{
  "resourceType": "Bundle",
  "type": "transaction",
  "entry": [ {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5",
    "resource": {
      "resourceType": "Patient",
      "id": "e63ee044-44a6-784d-28a0-0d049d2449a5",
      "text": {
        "status": "generated",
        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated by <a href=\"https://github.com/synthetichealth/synthea\">Synthea</a>.Version identifier: 7e08387\n .   Person seed: -1855799412615907251  Population seed: 1784730135182</div>"
      },
      "extension": [ {
        "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": "2106-3",
            "display": "White"
          }
        }, {
          "url": "text",
          "valueString": "White"
        } ]
      }, {
        "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
        "extension": [ {
          "url": "ombCategory",
          "valueCoding": {
            "system": "urn:oid:2.16.840.1.113883.6.238",
            "code": "2135-2",
            "display": "Hispanic or Latino"
          }
        }, {
          "url": "text",
          "valueString": "Hispanic or Latino"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
        "valueString": "Marilu588 Canales95"
      }, {
        "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
        "valueCode": "M"
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/birthPlace",
        "valueAddress": {
          "city": "Gaudalajara",
          "state": "Jalisco",
          "country": "MX"
        }
      }, {
        "url": "http://synthetichealth.github.io/synthea/disability-adjusted-life-years",
        "valueDecimal": 0.9449489086031999
      }, {
        "url": "http://synthetichealth.github.io/synthea/quality-adjusted-life-years",
        "valueDecimal": 65.0550510913968
      } ],
      "identifier": [ {
        "system": "https://github.com/synthetichealth/synthea",
        "value": "e63ee044-44a6-784d-28a0-0d049d2449a5"
      }, {
        "type": {
          "coding": [ {
            "system": "http://hl7.org/fhir/v2/0203",
            "code": "MR",
            "display": "Medical Record Number"
          } ],
          "text": "Medical Record Number"
        },
        "system": "http://hospital.smarthealthit.org",
        "value": "e63ee044-44a6-784d-28a0-0d049d2449a5"
      }, {
        "type": {
          "coding": [ {
            "system": "http://hl7.org/fhir/identifier-type",
            "code": "SB",
            "display": "Social Security Number"
          } ],
          "text": "Social Security Number"
        },
        "system": "http://hl7.org/fhir/sid/us-ssn",
        "value": "999-90-8789"
      }, {
        "type": {
          "coding": [ {
            "system": "http://hl7.org/fhir/v2/0203",
            "code": "DL",
            "display": "Driver's license number"
          } ],
          "text": "Driver's license number"
        },
        "system": "urn:oid:2.16.840.1.113883.4.3.25",
        "value": "S99998923"
      }, {
        "type": {
          "coding": [ {
            "system": "http://hl7.org/fhir/v2/0203",
            "code": "PPN",
            "display": "Passport Number"
          } ],
          "text": "Passport Number"
        },
        "system": "http://hl7.org/fhir/sid/passport-USA",
        "value": "X62166691X"
      } ],
      "name": [ {
        "use": "official",
        "family": "Calderón210",
        "given": [ "Julio255" ],
        "prefix": [ "Mr." ]
      } ],
      "telecom": [ {
        "system": "phone",
        "value": "555-131-5977",
        "use": "home"
      } ],
      "gender": "male",
      "birthDate": "1959-04-04",
      "address": [ {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/geolocation",
          "extension": [ {
            "url": "latitude",
            "valueDecimal": 42.31396057565151
          }, {
            "url": "longitude",
            "valueDecimal": -71.71266166213267
          } ]
        } ],
        "line": [ "315 Mann Key" ],
        "city": "Worcester",
        "state": "Massachusetts",
        "postalCode": "01606",
        "country": "US"
      } ],
      "maritalStatus": {
        "coding": [ {
          "system": "http://hl7.org/fhir/v3/MaritalStatus",
          "code": "S",
          "display": "S"
        } ],
        "text": "S"
      },
      "multipleBirthBoolean": false,
      "communication": [ {
        "language": {
          "coding": [ {
            "system": "urn:ietf:bcp:47",
            "code": "es",
            "display": "Spanish"
          } ],
          "text": "Spanish"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Patient"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cc89-b022dc8332a4",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-cc89-b022dc8332a4",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "1977-05-28T14:42:27+00:00",
        "end": "1977-05-28T15:13:43+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ba63-4ad547f2ff8d",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-ba63-4ad547f2ff8d",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "224299000",
          "display": "Received higher education (finding)"
        } ],
        "text": "Received higher education (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-cc89-b022dc8332a4"
      },
      "onsetDateTime": "1977-05-28T15:13:43+00:00",
      "assertedDate": "1977-05-28T15:13:43+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-eb77-ade2d4682350",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-eb77-ade2d4682350",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1977-05-28T14:42:27+00:00",
        "end": "1977-05-28T15:13:43+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ba63-4ad547f2ff8d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-cc89-b022dc8332a4"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:a1eac1fe-5c09-6f8d-ac77-a28e551b4625",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "a1eac1fe-5c09-6f8d-ac77-a28e551b4625",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-eb77-ade2d4682350"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "1977-05-28T15:13:43+00:00",
        "end": "1978-05-28T15:13:43+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ba63-4ad547f2ff8d"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 704.20,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 109.44000000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1ef1-75d54064defc",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-1ef1-75d54064defc",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185347001",
          "display": "Encounter for problem (procedure)"
        } ],
        "text": "Encounter for problem (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "1981-04-03T12:42:27+00:00",
        "end": "1981-04-03T12:57:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "40275004",
          "display": "Contact dermatitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4cf0-f8cecff88bb4",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-4cf0-f8cecff88bb4",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "106258",
          "display": "Hydrocortisone 10 MG/ML Topical Cream"
        } ],
        "text": "Hydrocortisone 10 MG/ML Topical Cream"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-1ef1-75d54064defc"
      },
      "authoredOn": "1981-04-03T12:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "dosageInstruction": [ {
        "sequence": 1,
        "asNeededBoolean": true
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9f7e-2cf890515dac",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-9f7e-2cf890515dac",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1981-04-03T12:42:27+00:00",
        "end": "1981-04-03T12:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4cf0-f8cecff88bb4"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-1ef1-75d54064defc"
        } ]
      } ],
      "total": {
        "value": 51.48,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4615-ddc780784d44",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-4615-ddc780784d44",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1981-04-03T12:42:27+00:00",
        "end": "1981-04-03T12:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-1ef1-75d54064defc"
        } ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:6f175387-f019-0cb5-0279-f6c0141ada33",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "6f175387-f019-0cb5-0279-f6c0141ada33",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-4615-ddc780784d44"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "1981-04-03T12:57:27+00:00",
        "end": "1982-04-03T12:57:27+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-87e4-22bab5ba414b",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-87e4-22bab5ba414b",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185347001",
          "display": "Encounter for problem (procedure)"
        } ],
        "text": "Encounter for problem (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "1981-04-18T02:42:27+00:00",
        "end": "1981-04-18T03:19:21+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "609328004",
          "display": "Allergic disposition (finding)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fb1c-9ba65e000939",
    "resource": {
      "resourceType": "AllergyIntolerance",
      "id": "e63ee044-44a6-784d-fb1c-9ba65e000939",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "type": "allergy",
      "category": [ "food" ],
      "criticality": "low",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "609328004",
          "display": "Allergic disposition (finding)"
        } ],
        "text": "Allergic disposition (finding)"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "assertedDate": "1981-04-18T02:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "AllergyIntolerance"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-068e-0d7ac09d2cc0",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-068e-0d7ac09d2cc0",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "1363309",
          "display": "Chlorpheniramine Maleate 4 MG Oral Tablet"
        } ],
        "text": "Chlorpheniramine Maleate 4 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-87e4-22bab5ba414b"
      },
      "authoredOn": "1981-04-18T03:19:21+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "dosageInstruction": [ {
        "sequence": 1,
        "asNeededBoolean": true
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d828-7e151edbfeb5",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-d828-7e151edbfeb5",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1981-04-18T02:42:27+00:00",
        "end": "1981-04-18T03:19:21+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-068e-0d7ac09d2cc0"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-87e4-22bab5ba414b"
        } ]
      } ],
      "total": {
        "value": 61.15,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e5ed-729c8eb373e8",
    "resource": {
      "resourceType": "CarePlan",
      "id": "e63ee044-44a6-784d-e5ed-729c8eb373e8",
      "status": "active",
      "intent": "order",
      "category": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "384758001",
          "display": "Self-care interventions (procedure)"
        } ],
        "text": "Self-care interventions (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-87e4-22bab5ba414b"
      },
      "period": {
        "start": "1981-04-18T03:19:21+00:00"
      },
      "activity": [ {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "58332002",
              "display": "Allergy education (procedure)"
            } ],
            "text": "Allergy education (procedure)"
          },
          "status": "in-progress"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "CarePlan"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1c3b-254b334ca6cd",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-1c3b-254b334ca6cd",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1981-04-18T02:42:27+00:00",
        "end": "1981-04-18T03:19:21+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-87e4-22bab5ba414b"
        } ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c777c5dd-6956-a26f-fce8-6eab72571827",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c777c5dd-6956-a26f-fce8-6eab72571827",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-1c3b-254b334ca6cd"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "1981-04-18T03:19:21+00:00",
        "end": "1982-04-18T03:19:21+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f99c-2ff98b550c74",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-f99c-2ff98b550c74",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "1990-06-16T14:42:27+00:00",
        "end": "1990-06-16T15:35:18+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6b87-87294c4cc2e5",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-6b87-87294c4cc2e5",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162864005",
          "display": "Body mass index 30+ - obesity (finding)"
        } ],
        "text": "Body mass index 30+ - obesity (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f99c-2ff98b550c74"
      },
      "onsetDateTime": "1990-06-16T14:42:27+00:00",
      "assertedDate": "1990-06-16T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e206-c1dd0770254e",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-e206-c1dd0770254e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1990-06-16T14:42:27+00:00",
        "end": "1990-06-16T15:35:18+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6b87-87294c4cc2e5"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f99c-2ff98b550c74"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:43c49b8b-b92e-8251-7be8-a5ccd83904f4",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "43c49b8b-b92e-8251-7be8-a5ccd83904f4",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-e206-c1dd0770254e"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "1990-06-16T15:35:18+00:00",
        "end": "1991-06-16T15:35:18+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6b87-87294c4cc2e5"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 778.78,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 109.44000000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-961c-90ab4d17af7a",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-961c-90ab4d17af7a",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "1996-06-22T14:42:27+00:00",
        "end": "1996-06-22T15:19:31+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-db58-c484239d86b4",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-db58-c484239d86b4",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "446654005",
          "display": "Refugee (person)"
        } ],
        "text": "Refugee (person)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-961c-90ab4d17af7a"
      },
      "onsetDateTime": "1996-06-22T15:19:31+00:00",
      "assertedDate": "1996-06-22T15:19:31+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0d32-8f8eefc10ff7",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-0d32-8f8eefc10ff7",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "1996-06-22T14:42:27+00:00",
        "end": "1996-06-22T15:19:31+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-db58-c484239d86b4"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-961c-90ab4d17af7a"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:dfde2647-7600-f3e9-e7c2-2b6b37528ffb",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "dfde2647-7600-f3e9-e7c2-2b6b37528ffb",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-0d32-8f8eefc10ff7"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "1996-06-22T15:19:31+00:00",
        "end": "1997-06-22T15:19:31+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-db58-c484239d86b4"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 778.78,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 109.44000000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e3ea-195dec325d36",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-e3ea-195dec325d36",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185347001",
          "display": "Encounter for problem (procedure)"
        } ],
        "text": "Encounter for problem (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2001-04-29T14:42:27+00:00",
        "end": "2001-04-29T14:57:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "239872002",
          "display": "Osteoarthritis of hip (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bddd-882b60d44388",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-bddd-882b60d44388",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "239872002",
          "display": "Osteoarthritis of hip (disorder)"
        } ],
        "text": "Osteoarthritis of hip (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e3ea-195dec325d36"
      },
      "onsetDateTime": "2001-04-29T14:42:27+00:00",
      "assertedDate": "2001-04-29T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1d04-520f36ed3302",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-1d04-520f36ed3302",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "849574",
          "display": "Naproxen sodium 220 MG Oral Tablet"
        } ],
        "text": "Naproxen sodium 220 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e3ea-195dec325d36"
      },
      "authoredOn": "2001-04-29T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-bddd-882b60d44388"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-efbb-fc6d54a4c3dc",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-efbb-fc6d54a4c3dc",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2001-04-29T14:42:27+00:00",
        "end": "2001-04-29T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-1d04-520f36ed3302"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-e3ea-195dec325d36"
        } ]
      } ],
      "total": {
        "value": 91.72,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-58c0-a60df7305761",
    "resource": {
      "resourceType": "CarePlan",
      "id": "e63ee044-44a6-784d-58c0-a60df7305761",
      "status": "active",
      "intent": "order",
      "category": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "408869004",
          "display": "Musculoskeletal care (regime/therapy)"
        } ],
        "text": "Musculoskeletal care (regime/therapy)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e3ea-195dec325d36"
      },
      "period": {
        "start": "2001-04-29T14:42:27+00:00"
      },
      "addresses": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-bddd-882b60d44388"
      } ],
      "activity": [ {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "386294003",
              "display": "Joint mobility exercises (regime/therapy)"
            } ],
            "text": "Joint mobility exercises (regime/therapy)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "266694003",
              "display": "Heat therapy (procedure)"
            } ],
            "text": "Heat therapy (procedure)"
          },
          "status": "in-progress"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "CarePlan"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-be65-6777c809d813",
    "resource": {
      "resourceType": "Device",
      "id": "e63ee044-44a6-784d-be65-6777c809d813",
      "udi": {
        "deviceIdentifier": "81397907112039",
        "carrierHRF": "(01)81397907112039(11)010408(17)260423(10)35479894548312(21)796729"
      },
      "status": "active",
      "type": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1255320005",
          "display": "Wheeled walker (physical object)"
        } ],
        "text": "Wheeled walker (physical object)"
      },
      "lotNumber": "35479894548312",
      "manufactureDate": "2001-04-08T14:42:27+00:00",
      "expirationDate": "2026-04-23T14:42:27+00:00",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      }
    },
    "request": {
      "method": "POST",
      "url": "Device"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7ece-994537004d0d",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-7ece-994537004d0d",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2001-04-29T14:42:27+00:00",
        "end": "2001-04-29T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-bddd-882b60d44388"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-e3ea-195dec325d36"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 3,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ff495b8f-816e-6bc7-8f9a-4e7b0778f8a8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "ff495b8f-816e-6bc7-8f9a-4e7b0778f8a8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-7ece-994537004d0d"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2001-04-29T14:57:27+00:00",
        "end": "2002-04-29T14:57:27+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-bddd-882b60d44388"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f8de-7e98d4f9260e",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-f8de-7e98d4f9260e",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2009-04-04T14:42:27+00:00",
        "end": "2009-04-04T15:23:14+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d809-6d2f4c5cc920",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-d809-6d2f4c5cc920",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "414545008",
          "display": "Ischemic heart disease (disorder)"
        } ],
        "text": "Ischemic heart disease (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f8de-7e98d4f9260e"
      },
      "onsetDateTime": "2009-04-04T14:42:27+00:00",
      "assertedDate": "2009-04-04T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-547d-a3bcb45eb22c",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-547d-a3bcb45eb22c",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-04-04T14:42:27+00:00",
        "end": "2009-04-04T15:23:14+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-d809-6d2f4c5cc920"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f8de-7e98d4f9260e"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ea1f8e34-545b-800d-03e0-af108149a822",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "ea1f8e34-545b-800d-03e0-af108149a822",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-547d-a3bcb45eb22c"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2009-04-04T15:23:14+00:00",
        "end": "2010-04-04T15:23:14+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-d809-6d2f4c5cc920"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 1601.54,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 109.44000000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-dfac-fe3b1214d3e2",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185349003",
          "display": "Encounter for check up (procedure)"
        } ],
        "text": "Encounter for check up (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2009-04-11T14:42:27+00:00",
        "end": "2009-04-11T15:09:47+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "275978004",
          "display": "Screening for malignant neoplasm of colon (procedure)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4d89-047f5b1942cb",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-4d89-047f5b1942cb",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "309362",
          "display": "Clopidogrel 75 MG Oral Tablet"
        } ],
        "text": "Clopidogrel 75 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
      },
      "authoredOn": "2009-04-11T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7d53-98ffa0f8fe0e",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-7d53-98ffa0f8fe0e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-04-11T14:42:27+00:00",
        "end": "2009-04-11T15:09:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4d89-047f5b1942cb"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
        } ]
      } ],
      "total": {
        "value": 353.15,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-04fc-3e2a5df74066",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-04fc-3e2a5df74066",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "312961",
          "display": "Simvastatin 20 MG Oral Tablet"
        } ],
        "text": "Simvastatin 20 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
      },
      "authoredOn": "2009-04-11T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9c33-710844709952",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-9c33-710844709952",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-04-11T14:42:27+00:00",
        "end": "2009-04-11T15:09:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-04fc-3e2a5df74066"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
        } ]
      } ],
      "total": {
        "value": 140.60,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-708e-26626097214b",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-708e-26626097214b",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "866412",
          "display": "24 HR metoprolol succinate 100 MG Extended Release Oral Tablet"
        } ],
        "text": "24 HR metoprolol succinate 100 MG Extended Release Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
      },
      "authoredOn": "2009-04-11T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1ba8-581a50e510f7",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-1ba8-581a50e510f7",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-04-11T14:42:27+00:00",
        "end": "2009-04-11T15:09:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-708e-26626097214b"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
        } ]
      } ],
      "total": {
        "value": 129.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c060-8099769e832b",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-c060-8099769e832b",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "705129",
          "display": "Nitroglycerin 0.4 MG/ACTUAT Mucosal Spray"
        } ],
        "text": "Nitroglycerin 0.4 MG/ACTUAT Mucosal Spray"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
      },
      "authoredOn": "2009-04-11T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9bc8-290e2fd3d396",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-9bc8-290e2fd3d396",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-04-11T14:42:27+00:00",
        "end": "2009-04-11T15:09:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-c060-8099769e832b"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
        } ]
      } ],
      "total": {
        "value": 369.29,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-52fd-fea5f0e16547",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-52fd-fea5f0e16547",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-04-11T14:42:27+00:00",
        "end": "2009-04-11T15:09:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-dfac-fe3b1214d3e2"
        } ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:16ecb573-7c6c-2492-8734-ec87bb1729d8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "16ecb573-7c6c-2492-8734-ec87bb1729d8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-52fd-fea5f0e16547"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2009-04-11T15:09:47+00:00",
        "end": "2010-04-11T15:09:47+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 8771.67,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e0dd-694bfbc2812b",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-e0dd-694bfbc2812b",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185347001",
          "display": "Encounter for problem (procedure)"
        } ],
        "text": "Encounter for problem (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999984591",
          "display": "Dr. Gabriel934 Reilly981"
        }
      } ],
      "period": {
        "start": "2009-05-01T01:34:04+00:00",
        "end": "2009-05-01T06:33:26+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "414545008",
          "display": "Ischemic heart disease (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|74ab949d-17ac-3309-83a0-13b4405c66aa",
        "display": "Fitchburg Outpatient Clinic"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f144-0702ad95645d",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-f144-0702ad95645d",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "274531002",
          "display": "Abnormal findings diagnostic imaging heart+coronary circulat (finding)"
        } ],
        "text": "Abnormal findings diagnostic imaging heart+coronary circulat (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e0dd-694bfbc2812b"
      },
      "onsetDateTime": "2009-05-01T03:40:11+00:00",
      "assertedDate": "2009-05-01T03:40:11+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d58c-007ea01c416a",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-d58c-007ea01c416a",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2009-05-01T01:34:04+00:00",
        "end": "2009-05-01T06:33:26+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|74ab949d-17ac-3309-83a0-13b4405c66aa",
        "display": "Fitchburg Outpatient Clinic"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f144-0702ad95645d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-e0dd-694bfbc2812b"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:fd804640-8eba-de64-3f39-b090b43511e7",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "fd804640-8eba-de64-3f39-b090b43511e7",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-d58c-007ea01c416a"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2009-05-01T06:33:26+00:00",
        "end": "2010-05-01T06:33:26+00:00"
      },
      "provider": {
        "identifier": {
          "value": "5a26622e-a116-3ad0-9175-53a9b54ea558"
        }
      },
      "organization": {
        "identifier": {
          "value": "74ab949d-17ac-3309-83a0-13b4405c66aa"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999984591"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f144-0702ad95645d"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 1444.46,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-18d9-a5a6c5497c0a",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-18d9-a5a6c5497c0a",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "702927004",
          "display": "Urgent care clinic (environment)"
        } ],
        "text": "Urgent care clinic (environment)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999939991",
          "display": "Dr. Bud153 Parisian75"
        }
      } ],
      "period": {
        "start": "2010-02-27T14:42:27+00:00",
        "end": "2010-02-27T15:39:14+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ab701a70-a658-340e-8f69-ee196a7d40c6",
        "display": "CAREWELL URGENT CARE CENTERS OF MA, PC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9ebb-3d0571a0b8d2",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-9ebb-3d0571a0b8d2",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "714628002",
          "display": "Prediabetes (finding)"
        } ],
        "text": "Prediabetes (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-18d9-a5a6c5497c0a"
      },
      "onsetDateTime": "2010-02-27T14:42:27+00:00",
      "assertedDate": "2010-02-27T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-337f-0dec320977cd",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-337f-0dec320977cd",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "271737000",
          "display": "Anemia (disorder)"
        } ],
        "text": "Anemia (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-18d9-a5a6c5497c0a"
      },
      "onsetDateTime": "2010-02-27T14:42:27+00:00",
      "assertedDate": "2010-02-27T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0d00-c91c37fc8cd8",
    "resource": {
      "resourceType": "CarePlan",
      "id": "e63ee044-44a6-784d-0d00-c91c37fc8cd8",
      "status": "active",
      "intent": "order",
      "category": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "735985000",
          "display": "Diabetes self management plan (record artifact)"
        } ],
        "text": "Diabetes self management plan (record artifact)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-18d9-a5a6c5497c0a"
      },
      "period": {
        "start": "2010-02-27T14:42:27+00:00"
      },
      "addresses": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ebb-3d0571a0b8d2"
      } ],
      "activity": [ {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "160670007",
              "display": "Diabetic diet (finding)"
            } ],
            "text": "Diabetic diet (finding)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "229065009",
              "display": "Exercise therapy (regime/therapy)"
            } ],
            "text": "Exercise therapy (regime/therapy)"
          },
          "status": "in-progress"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "CarePlan"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fab0-d20e2fdcac99",
    "resource": {
      "resourceType": "Device",
      "id": "e63ee044-44a6-784d-fab0-d20e2fdcac99",
      "udi": {
        "deviceIdentifier": "70797250363966",
        "carrierHRF": "(01)70797250363966(11)100206(17)350221(10)34436262085123(21)5523"
      },
      "status": "active",
      "type": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "337414009",
          "display": "Blood glucose meter (physical object)"
        } ],
        "text": "Blood glucose meter (physical object)"
      },
      "lotNumber": "34436262085123",
      "manufactureDate": "2010-02-06T14:42:27+00:00",
      "expirationDate": "2035-02-21T14:42:27+00:00",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      }
    },
    "request": {
      "method": "POST",
      "url": "Device"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-39d2-b7c16f1d071b",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-39d2-b7c16f1d071b",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2010-02-27T14:42:27+00:00",
        "end": "2010-02-27T15:39:14+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ab701a70-a658-340e-8f69-ee196a7d40c6",
        "display": "CAREWELL URGENT CARE CENTERS OF MA, PC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9ebb-3d0571a0b8d2"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-337f-0dec320977cd"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-18d9-a5a6c5497c0a"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 3,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 63.64,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 2 ]
      } ],
      "total": {
        "value": 206.22,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e91a4fce-969d-538d-02db-70b161d7b7a2",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "e91a4fce-969d-538d-02db-70b161d7b7a2",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999939991"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999939991"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-39d2-b7c16f1d071b"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2010-02-27T15:39:14+00:00",
        "end": "2011-02-27T15:39:14+00:00"
      },
      "created": "2010-02-27T15:39:14+00:00",
      "provider": {
        "identifier": {
          "value": "a0aa193d-bbc6-3046-9a66-982a18a4c8a6"
        }
      },
      "organization": {
        "identifier": {
          "value": "ab701a70-a658-340e-8f69-ee196a7d40c6"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:e63ee044-44a6-784d-39d2-b7c16f1d071b"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999939991"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9ebb-3d0571a0b8d2"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-337f-0dec320977cd"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-02-27T14:42:27+00:00",
          "end": "2010-02-27T15:39:14+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-18d9-a5a6c5497c0a"
        } ],
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 28.516000000000005,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 114.06400000000002,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 142.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 142.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-02-27T14:42:27+00:00",
          "end": "2010-02-27T15:39:14+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        }
      }, {
        "sequence": 3,
        "informationLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-02-27T14:42:27+00:00",
          "end": "2010-02-27T15:39:14+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "net": {
          "value": 63.64,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 12.728000000000002,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 50.912000000000006,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 63.64,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 63.64,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 2 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-02-27T14:42:27+00:00",
          "end": "2010-02-27T15:39:14+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        }
      } ],
      "totalCost": {
        "value": 984.20,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 164.97600000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4fdc-711fcefa0c51",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-4fdc-711fcefa0c51",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185347001",
          "display": "Encounter for problem (procedure)"
        } ],
        "text": "Encounter for problem (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2014-02-03T14:42:27+00:00",
        "end": "2014-02-03T14:57:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "82423001",
          "display": "Chronic pain (finding)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-daa2-43877f8f8e3e",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-daa2-43877f8f8e3e",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "82423001",
          "display": "Chronic pain (finding)"
        } ],
        "text": "Chronic pain (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4fdc-711fcefa0c51"
      },
      "onsetDateTime": "2014-02-03T14:42:27+00:00",
      "assertedDate": "2014-02-03T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3146-29a76a800351",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-3146-29a76a800351",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "278860009",
          "display": "Chronic low back pain (finding)"
        } ],
        "text": "Chronic low back pain (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4fdc-711fcefa0c51"
      },
      "onsetDateTime": "2014-02-03T14:42:27+00:00",
      "assertedDate": "2014-02-03T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5274-0fdc6d3f6c06",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-5274-0fdc6d3f6c06",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1121000119107",
          "display": "Chronic neck pain (finding)"
        } ],
        "text": "Chronic neck pain (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4fdc-711fcefa0c51"
      },
      "onsetDateTime": "2014-02-03T14:42:27+00:00",
      "assertedDate": "2014-02-03T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ae6c-27b187ecde8f",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-ae6c-27b187ecde8f",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2014-02-03T14:42:27+00:00",
        "end": "2014-02-03T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-daa2-43877f8f8e3e"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3146-29a76a800351"
        }
      }, {
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5274-0fdc6d3f6c06"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-4fdc-711fcefa0c51"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 3 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:d87c4c3f-9ce3-2a30-10a0-6c360e7d2cd4",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "d87c4c3f-9ce3-2a30-10a0-6c360e7d2cd4",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999988196"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-ae6c-27b187ecde8f"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2014-02-03T14:57:27+00:00",
        "end": "2015-02-03T14:57:27+00:00"
      },
      "created": "2014-02-03T14:57:27+00:00",
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ae6c-27b187ecde8f"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-daa2-43877f8f8e3e"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3146-29a76a800351"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5274-0fdc6d3f6c06"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2014-02-03T14:42:27+00:00",
          "end": "2014-02-03T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-4fdc-711fcefa0c51"
        } ],
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2014-02-03T14:42:27+00:00",
          "end": "2014-02-03T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 2 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2014-02-03T14:42:27+00:00",
          "end": "2014-02-03T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 3 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2014-02-03T14:42:27+00:00",
          "end": "2014-02-03T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f8c4-d355b5bcef4a",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-f8c4-d355b5bcef4a",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2016-05-14T14:42:27+00:00",
        "end": "2016-05-14T15:32:30+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-27ea-1e1099ec643c",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-27ea-1e1099ec643c",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "160903007",
          "display": "Full-time employment (finding)"
        } ],
        "text": "Full-time employment (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f8c4-d355b5bcef4a"
      },
      "onsetDateTime": "2016-05-14T15:32:30+00:00",
      "abatementDateTime": "2025-07-05T15:21:25+00:00",
      "assertedDate": "2016-05-14T15:32:30+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0455-9937955d9930",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-0455-9937955d9930",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "422650009",
          "display": "Social isolation (finding)"
        } ],
        "text": "Social isolation (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f8c4-d355b5bcef4a"
      },
      "onsetDateTime": "2016-05-14T15:32:30+00:00",
      "assertedDate": "2016-05-14T15:32:30+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6e93-f84b4e84c58b",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-6e93-f84b4e84c58b",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73595000",
          "display": "Stress (finding)"
        } ],
        "text": "Stress (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f8c4-d355b5bcef4a"
      },
      "onsetDateTime": "2016-05-14T15:32:30+00:00",
      "abatementDateTime": "2018-05-26T15:23:17+00:00",
      "assertedDate": "2016-05-14T15:32:30+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c5b3-44f76524248a",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-c5b3-44f76524248a",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2016-05-14T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d240-d10b6ae14024",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-d240-d10b6ae14024",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2016-05-14T14:42:27+00:00",
        "end": "2016-05-14T15:32:30+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-27ea-1e1099ec643c"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0455-9937955d9930"
        }
      }, {
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6e93-f84b4e84c58b"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f8c4-d355b5bcef4a"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 5,
        "diagnosisLinkId": [ 3 ]
      } ],
      "total": {
        "value": 143.60,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:d532f1ec-ebdd-114d-4044-6601059e325e",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "d532f1ec-ebdd-114d-4044-6601059e325e",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-d240-d10b6ae14024"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2016-05-14T15:32:30+00:00",
        "end": "2017-05-14T15:32:30+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-27ea-1e1099ec643c"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0455-9937955d9930"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6e93-f84b4e84c58b"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 1722.96,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 114.88000000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-5cf2-b9e5cc497e0f",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2017-05-20T14:42:27+00:00",
        "end": "2017-05-20T15:12:47+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-9e31-3f1b0d0d308c",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "59621000",
          "display": "Essential hypertension (disorder)"
        } ],
        "text": "Essential hypertension (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "onsetDateTime": "2017-05-20T14:42:27+00:00",
      "assertedDate": "2017-05-20T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8287-f7733aab0703",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-8287-f7733aab0703",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "onsetDateTime": "2017-05-20T14:42:27+00:00",
      "abatementDateTime": "2019-06-01T14:42:27+00:00",
      "assertedDate": "2017-05-20T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a63b-a71c81f2bc61",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-a63b-a71c81f2bc61",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "237602007",
          "display": "Metabolic syndrome X (disorder)"
        } ],
        "text": "Metabolic syndrome X (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "onsetDateTime": "2017-05-20T14:42:27+00:00",
      "assertedDate": "2017-05-20T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-643c-14ebebc306d6",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-643c-14ebebc306d6",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "423315002",
          "display": "Limited social contact (finding)"
        } ],
        "text": "Limited social contact (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "onsetDateTime": "2017-05-20T15:12:47+00:00",
      "abatementDateTime": "2019-06-01T15:22:55+00:00",
      "assertedDate": "2017-05-20T15:12:47+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-5ed4-66c960d03b3c",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ],
        "text": "Gingivitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "onsetDateTime": "2017-05-20T16:25:11+00:00",
      "abatementDateTime": "2017-06-03T17:43:00+00:00",
      "assertedDate": "2017-05-20T16:25:11+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f489-57042ed4b589",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f489-57042ed4b589",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.2900,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-12b7-6365ecc0060e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-12b7-6365ecc0060e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-978a-3d7abcc226e8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-978a-3d7abcc226e8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2027-7bd19e312c41",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2027-7bd19e312c41",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-75cc-2bf4f505b99c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-75cc-2bf4f505b99c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a3b4-2b95d4bcb6c5",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a3b4-2b95d4bcb6c5",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 93,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 134,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e10f-f5d073f31f83",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e10f-f5d073f31f83",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 88,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-15a8-2312e78c55c0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-15a8-2312e78c55c0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7123-926e990c6db1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7123-926e990c6db1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 95.350,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b9f6-516854472e61",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b9f6-516854472e61",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 7.4800,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f952-fa71dd22bb15",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f952-fa71dd22bb15",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0.93000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bcbe-ee09c9d3026f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-bcbe-ee09c9d3026f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.5100,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f9f4-7ffd143d5fca",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f9f4-7ffd143d5fca",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 136.79,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-39a8-8a18baaf8ce8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-39a8-8a18baaf8ce8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 5.0100,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-efea-5da32bc58537",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-efea-5da32bc58537",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 106.01,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6fe8-6f3e39e0512a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6fe8-6f3e39e0512a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 21.130,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ad2c-7610734abb82",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ad2c-7610734abb82",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1d68-1429e7f96be3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1d68-1429e7f96be3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T15:12:47+00:00",
      "issued": "2017-05-20T15:12:47.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA13863-8",
            "display": "A little bit"
          } ],
          "text": "A little bit"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30130-1",
            "display": "1 or 2 times a week"
          } ],
          "text": "1 or 2 times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dcc2-497aba0f851e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-dcc2-497aba0f851e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55758-7",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T15:43:06+00:00",
      "issued": "2017-05-20T15:43:06.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a611-ae8c653953ef",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a611-ae8c653953ef",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "82667-7",
          "display": "Total score [DAST-10]"
        } ],
        "text": "Total score [DAST-10]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T16:25:11+00:00",
      "issued": "2017-05-20T16:25:11.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b918-569774603a49",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-b918-569774603a49",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "performedPeriod": {
        "start": "2017-05-20T14:42:27+00:00",
        "end": "2017-05-20T15:12:47+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a021-93ad17561694",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-a021-93ad17561694",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "performedPeriod": {
        "start": "2017-05-20T15:12:47+00:00",
        "end": "2017-05-20T15:22:58+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2069-d626ce9b0d70",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-2069-d626ce9b0d70",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "performedPeriod": {
        "start": "2017-05-20T15:22:58+00:00",
        "end": "2017-05-20T15:43:06+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c84d-67662d7fd9df",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-c84d-67662d7fd9df",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "performedPeriod": {
        "start": "2017-05-20T15:43:06+00:00",
        "end": "2017-05-20T15:57:29+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-19ac-f8b85e6bb2b8",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-19ac-f8b85e6bb2b8",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "713106006",
          "display": "Screening for drug abuse (procedure)"
        } ],
        "text": "Screening for drug abuse (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "performedPeriod": {
        "start": "2017-05-20T15:57:29+00:00",
        "end": "2017-05-20T16:25:11+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c2ee-c8970e316eaf",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-c2ee-c8970e316eaf",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "103697008",
          "display": "Patient referral for dental care (procedure)"
        } ],
        "text": "Patient referral for dental care (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "performedPeriod": {
        "start": "2017-05-20T16:25:11+00:00",
        "end": "2017-05-20T16:36:29+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4e22-81853031cbaa",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-4e22-81853031cbaa",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "authoredOn": "2017-05-20T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fed8-8a9f13add75e",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-fed8-8a9f13add75e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-05-20T14:42:27+00:00",
        "end": "2017-05-20T15:12:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4e22-81853031cbaa"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0a6e-dad6f3090a28",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-0a6e-dad6f3090a28",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "authoredOn": "2017-05-20T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-77fe-bebc308e83ee",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-77fe-bebc308e83ee",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-05-20T14:42:27+00:00",
        "end": "2017-05-20T15:12:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-0a6e-dad6f3090a28"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
        } ]
      } ],
      "total": {
        "value": 0.88,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5374-a8563acae7ce",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-5374-a8563acae7ce",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "date": "2017-05-20T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e9ad-e52bc0fd2784",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-e9ad-e52bc0fd2784",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T14:42:27+00:00",
      "issued": "2017-05-20T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-7123-926e990c6db1",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b9f6-516854472e61",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f952-fa71dd22bb15",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-bcbe-ee09c9d3026f",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f9f4-7ffd143d5fca",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-39a8-8a18baaf8ce8",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-efea-5da32bc58537",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-6fe8-6f3e39e0512a",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-200f-8f1d18cc5120",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-200f-8f1d18cc5120",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55757-9",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T15:43:06+00:00",
      "issued": "2017-05-20T15:43:06.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-dcc2-497aba0f851e",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fca8-10fb2dba0ff4",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-fca8-10fb2dba0ff4",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "82666-9",
          "display": "Drug Abuse Screening Test-10 [DAST-10]"
        } ],
        "text": "Drug Abuse Screening Test-10 [DAST-10]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "effectiveDateTime": "2017-05-20T16:25:11+00:00",
      "issued": "2017-05-20T16:25:11.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-a611-ae8c653953ef",
        "display": "Total score [DAST-10]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-17ad-2f18f32e9385",
    "resource": {
      "resourceType": "CarePlan",
      "id": "e63ee044-44a6-784d-17ad-2f18f32e9385",
      "status": "active",
      "intent": "order",
      "category": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "443402002",
          "display": "Lifestyle education regarding hypertension (procedure)"
        } ],
        "text": "Lifestyle education regarding hypertension (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
      },
      "period": {
        "start": "2017-05-20T14:42:27+00:00"
      },
      "addresses": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "activity": [ {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "386463000",
              "display": "Prescribed activity/exercise education (procedure)"
            } ],
            "text": "Prescribed activity/exercise education (procedure)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "413473000",
              "display": "Counseling about alcohol consumption (procedure)"
            } ],
            "text": "Counseling about alcohol consumption (procedure)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "1151000175103",
              "display": "Dietary Approaches to Stop Hypertension diet (regime/therapy)"
            } ],
            "text": "Dietary Approaches to Stop Hypertension diet (regime/therapy)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "225323000",
              "display": "Smoking cessation education (procedure)"
            } ],
            "text": "Smoking cessation education (procedure)"
          },
          "status": "in-progress"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "CarePlan"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7eeb-46cbb917eb60",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-7eeb-46cbb917eb60",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-05-20T14:42:27+00:00",
        "end": "2017-05-20T15:12:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5374-a8563acae7ce"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-8287-f7733aab0703"
        }
      }, {
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-a63b-a71c81f2bc61"
        }
      }, {
        "sequence": 4,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-643c-14ebebc306d6"
        }
      }, {
        "sequence": 5,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-b918-569774603a49"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-a021-93ad17561694"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-2069-d626ce9b0d70"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c84d-67662d7fd9df"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-19ac-f8b85e6bb2b8"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c2ee-c8970e316eaf"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-5cf2-b9e5cc497e0f"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 5,
        "diagnosisLinkId": [ 3 ]
      }, {
        "sequence": 6,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "diagnosisLinkId": [ 4 ]
      }, {
        "sequence": 9,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "713106006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "diagnosisLinkId": [ 5 ]
      }, {
        "sequence": 16,
        "procedureLinkId": [ 6 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "103697008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3084.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e9a50304-47ea-df0d-0366-241c2993a722",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "e9a50304-47ea-df0d-0366-241c2993a722",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-7eeb-46cbb917eb60"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2017-05-20T15:12:47+00:00",
        "end": "2018-05-20T15:12:47+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-8287-f7733aab0703"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-a63b-a71c81f2bc61"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 4,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-643c-14ebebc306d6"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 5,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "713106006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 16,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "103697008"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 778.78,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2467.952,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-d346-617d8c2f03de",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185349003",
          "display": "Encounter for check up (procedure)"
        } ],
        "text": "Encounter for check up (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2017-06-03T14:42:27+00:00",
        "end": "2017-06-03T19:05:19+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bfb6-03414bbb28cb",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-bfb6-03414bbb28cb",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "109570002",
          "display": "Primary dental caries (disorder)"
        } ],
        "text": "Primary dental caries (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "onsetDateTime": "2017-06-03T17:43:00+00:00",
      "abatementDateTime": "2017-06-03T18:24:31+00:00",
      "assertedDate": "2017-06-03T17:43:00+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a692-522e7df42001",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-a692-522e7df42001",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "34043003",
          "display": "Dental consultation and report (procedure)"
        } ],
        "text": "Dental consultation and report (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T14:42:27+00:00",
        "end": "2017-06-03T15:20:19+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b2d2-cda665b0acf0",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-b2d2-cda665b0acf0",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "225362009",
          "display": "Dental care (regime/therapy)"
        } ],
        "text": "Dental care (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T15:20:19+00:00",
        "end": "2017-06-03T15:31:46+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ae81-8ce8679b72ba",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-ae81-8ce8679b72ba",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1260009003",
          "display": "Removal of supragingival plaque and calculus from all teeth using dental instrument (procedure)"
        } ],
        "text": "Removal of supragingival plaque and calculus from all teeth using dental instrument (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T15:31:46+00:00",
        "end": "2017-06-03T16:10:11+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3663-b022c803c775",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-3663-b022c803c775",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1260010008",
          "display": "Removal of subgingival plaque and calculus from all teeth using dental instrument (procedure)"
        } ],
        "text": "Removal of subgingival plaque and calculus from all teeth using dental instrument (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T16:10:11+00:00",
        "end": "2017-06-03T16:44:03+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2eea-ce8da7b00f03",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-2eea-ce8da7b00f03",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "274788003",
          "display": "Examination of gingivae (procedure)"
        } ],
        "text": "Examination of gingivae (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T16:44:03+00:00",
        "end": "2017-06-03T17:43:00+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7b1a-71dc24205f03",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-7b1a-71dc24205f03",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1256042007",
          "display": "Restoration of tooth with coverage of all cusps using dental filling material (procedure)"
        } ],
        "text": "Restoration of tooth with coverage of all cusps using dental filling material (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T17:43:00+00:00",
        "end": "2017-06-03T18:24:31+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-bfb6-03414bbb28cb",
        "display": "Primary dental caries (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c5c1-36afe6ecf8c1",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-c5c1-36afe6ecf8c1",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "68071007",
          "display": "Dental fluoride treatment (procedure)"
        } ],
        "text": "Dental fluoride treatment (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T18:24:31+00:00",
        "end": "2017-06-03T18:50:13+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3163-44874f1479eb",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-3163-44874f1479eb",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "243085009",
          "display": "Oral health education (procedure)"
        } ],
        "text": "Oral health education (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "performedPeriod": {
        "start": "2017-06-03T18:50:13+00:00",
        "end": "2017-06-03T19:05:19+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4a83-d15b5a9276ae",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-4a83-d15b5a9276ae",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "1535362",
          "display": "sodium fluoride 0.0272 MG/MG Oral Gel"
        } ],
        "text": "sodium fluoride 0.0272 MG/MG Oral Gel"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "authoredOn": "2017-06-03T18:24:31+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-07d0-397f2138d95e",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-07d0-397f2138d95e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-06-03T14:42:27+00:00",
        "end": "2017-06-03T19:05:19+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4a83-d15b5a9276ae"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
        } ]
      } ],
      "total": {
        "value": 129.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ad650dd4-9c26-9617-f5ab-1877e3e3dc87",
    "resource": {
      "resourceType": "MedicationAdministration",
      "id": "ad650dd4-9c26-9617-f5ab-1877e3e3dc87",
      "status": "completed",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "1535362",
          "display": "sodium fluoride 0.0272 MG/MG Oral Gel"
        } ],
        "text": "sodium fluoride 0.0272 MG/MG Oral Gel"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
      },
      "effectiveDateTime": "2017-06-03T18:24:31+00:00",
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationAdministration"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ce64-248261d5b2d8",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-ce64-248261d5b2d8",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 1
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "277183007",
            "display": "Dental equipment (physical object)"
          } ],
          "text": "Dental equipment (physical object)"
        }
      },
      "occurrenceDateTime": "2017-06-03T15:31:46+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-346f-c731ea388ef3",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-346f-c731ea388ef3",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 1
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "1230220004",
            "display": "Conventional release periodontal gel (dose form)"
          } ],
          "text": "Conventional release periodontal gel (dose form)"
        }
      },
      "occurrenceDateTime": "2017-06-03T15:31:46+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f2a7-fc2e62734c42",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-f2a7-fc2e62734c42",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 1
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "469020004",
            "display": "Dental floss (physical object)"
          } ],
          "text": "Dental floss (physical object)"
        }
      },
      "occurrenceDateTime": "2017-06-03T15:31:46+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bcb4-9bdae3665df2",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-bcb4-9bdae3665df2",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-06-03T14:42:27+00:00",
        "end": "2017-06-03T19:05:19+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-bfb6-03414bbb28cb"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-a692-522e7df42001"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-b2d2-cda665b0acf0"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ae81-8ce8679b72ba"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3663-b022c803c775"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-2eea-ce8da7b00f03"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-7b1a-71dc24205f03"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c5c1-36afe6ecf8c1"
        }
      }, {
        "sequence": 8,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3163-44874f1479eb"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-d346-617d8c2f03de"
        } ]
      }, {
        "sequence": 2,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "34043003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "225362009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260009003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260010008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "274788003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 11,
        "procedureLinkId": [ 6 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1256042007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 7 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "68071007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "procedureLinkId": [ 8 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "243085009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3536.75,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:b1fcc9b8-d75a-3945-f251-30bd5bbae04c",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "b1fcc9b8-d75a-3945-f251-30bd5bbae04c",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-bcb4-9bdae3665df2"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2017-06-03T19:05:19+00:00",
        "end": "2018-06-03T19:05:19+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-bfb6-03414bbb28cb"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "34043003"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "225362009"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260009003"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260010008"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "274788003"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1256042007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "68071007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "243085009"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 3536.75,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2829.3999999999996,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8976-646d600bc999",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-8976-646d600bc999",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "390906007",
          "display": "Follow-up encounter (procedure)"
        } ],
        "text": "Follow-up encounter (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2017-06-19T14:42:27+00:00",
        "end": "2017-06-19T14:57:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "59621000",
          "display": "Essential hypertension (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-93cd-8cd143892312",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-93cd-8cd143892312",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8976-646d600bc999"
      },
      "effectiveDateTime": "2017-06-19T14:42:27+00:00",
      "issued": "2017-06-19T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 84,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 119,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6851-82a5f8781ac1",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-6851-82a5f8781ac1",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8976-646d600bc999"
      },
      "authoredOn": "2017-06-19T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c978-d8f3d46e3e28",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-c978-d8f3d46e3e28",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-06-19T14:42:27+00:00",
        "end": "2017-06-19T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-6851-82a5f8781ac1"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-8976-646d600bc999"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8832-03f7d1b23d72",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-8832-03f7d1b23d72",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2017-06-19T14:42:27+00:00",
        "end": "2017-06-19T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-8976-646d600bc999"
        } ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c811260a-99e9-f39f-c962-c21cab71b618",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c811260a-99e9-f39f-c962-c21cab71b618",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-8832-03f7d1b23d72"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2017-06-19T14:57:27+00:00",
        "end": "2018-06-19T14:57:27+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-9ccf-ee4a385e147e",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2018-05-26T14:42:27+00:00",
        "end": "2018-05-26T15:23:17+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0df8-97c098d4103d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-0df8-97c098d4103d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.0600,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9df0-ab59dfe53a97",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9df0-ab59dfe53a97",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5037-1fce3d7ca434",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-5037-1fce3d7ca434",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a7a7-e75c307f6d92",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a7a7-e75c307f6d92",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-db10-abdd65898e55",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-db10-abdd65898e55",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7f77-d3452ff889a3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7f77-d3452ff889a3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 70,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 97,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f902-7b361f1fe6d1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f902-7b361f1fe6d1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 87,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6fec-b48817604fe6",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6fec-b48817604fe6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-872b-fd5fef937cf2",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-872b-fd5fef937cf2",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 70.420,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1337-568179335be0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1337-568179335be0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 17.170,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dd4c-ed35a99d18da",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-dd4c-ed35a99d18da",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1.1900,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3de4-ed4387767193",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3de4-ed4387767193",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 8.5400,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9fa9-1cdcf8b98aa5",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9fa9-1cdcf8b98aa5",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 136.99,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d6a7-86ae36816e86",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d6a7-86ae36816e86",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 4.5200,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3b2a-6931aadb6fa6",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3b2a-6931aadb6fa6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 108.03,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3bee-e7ec21d9a3a5",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3bee-e7ec21d9a3a5",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 23.900,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-50d0-ad090bd63f41",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-50d0-ad090bd63f41",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2093-3",
          "display": "Cholesterol [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Cholesterol [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 126.02,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d8ea-86fe4dc4e557",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d8ea-86fe4dc4e557",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2571-8",
          "display": "Triglyceride [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Triglyceride [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 130.95,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b59a-4dc86f92d35b",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b59a-4dc86f92d35b",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "18262-6",
          "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
        } ],
        "text": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 72.410,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2c19-882ee79b8e96",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2c19-882ee79b8e96",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2085-9",
          "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.420,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f583-46a6c5ac8a33",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f583-46a6c5ac8a33",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5f3c-a25a9705eaf1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-5f3c-a25a9705eaf1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T15:23:17+00:00",
      "issued": "2018-05-26T15:23:17.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA6568-5",
            "display": "Not at all"
          } ],
          "text": "Not at all"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30130-1",
            "display": "1 or 2 times a week"
          } ],
          "text": "1 or 2 times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4896-fcf6a88d5203",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4896-fcf6a88d5203",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "70274-6",
          "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T15:46:23+00:00",
      "issued": "2018-05-26T15:46:23.042+00:00",
      "valueQuantity": {
        "value": 4,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d2e1-257de9a012e3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d2e1-257de9a012e3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55758-7",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T16:29:08+00:00",
      "issued": "2018-05-26T16:29:08.042+00:00",
      "valueQuantity": {
        "value": 3,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ff47-a4f2ffdf6603",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ff47-a4f2ffdf6603",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "44261-6",
          "display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T16:54:02+00:00",
      "issued": "2018-05-26T16:54:02.042+00:00",
      "valueQuantity": {
        "value": 11,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9649-8d7325226ab9",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-9649-8d7325226ab9",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "performedPeriod": {
        "start": "2018-05-26T14:42:27+00:00",
        "end": "2018-05-26T15:23:17+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7421-f4b2cf387cc5",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-7421-f4b2cf387cc5",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710841007",
          "display": "Assessment of anxiety (procedure)"
        } ],
        "text": "Assessment of anxiety (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "performedPeriod": {
        "start": "2018-05-26T15:23:17+00:00",
        "end": "2018-05-26T15:46:23+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-29d0-b8e4854b83fe",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-29d0-b8e4854b83fe",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "performedPeriod": {
        "start": "2018-05-26T15:46:23+00:00",
        "end": "2018-05-26T15:59:31+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-149b-fc7af06de876",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-149b-fc7af06de876",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "performedPeriod": {
        "start": "2018-05-26T15:59:31+00:00",
        "end": "2018-05-26T16:29:08+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c206-4dc67351fc86",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-c206-4dc67351fc86",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "715252007",
          "display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
        } ],
        "text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "performedPeriod": {
        "start": "2018-05-26T16:29:08+00:00",
        "end": "2018-05-26T16:54:02+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1042-55aa485cf048",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-1042-55aa485cf048",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "authoredOn": "2018-05-26T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d5bd-33b55ef53d48",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-d5bd-33b55ef53d48",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2018-05-26T14:42:27+00:00",
        "end": "2018-05-26T15:23:17+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-1042-55aa485cf048"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-04cd-dd649eacced9",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-04cd-dd649eacced9",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "authoredOn": "2018-05-26T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-93f1-9a34677b12c9",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-93f1-9a34677b12c9",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2018-05-26T14:42:27+00:00",
        "end": "2018-05-26T15:23:17+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-04cd-dd649eacced9"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-aced-1f2bc6de0cb3",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-aced-1f2bc6de0cb3",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "date": "2018-05-26T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b0ab-e241a8b3a3d0",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-b0ab-e241a8b3a3d0",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-872b-fd5fef937cf2",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-1337-568179335be0",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-dd4c-ed35a99d18da",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-3de4-ed4387767193",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9fa9-1cdcf8b98aa5",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-d6a7-86ae36816e86",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-3b2a-6931aadb6fa6",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-3bee-e7ec21d9a3a5",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-19be-1bb2e18d7c22",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-19be-1bb2e18d7c22",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "57698-3",
          "display": "Lipid panel with direct LDL - Serum or Plasma"
        } ],
        "text": "Lipid panel with direct LDL - Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T14:42:27+00:00",
      "issued": "2018-05-26T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-50d0-ad090bd63f41",
        "display": "Cholesterol [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-d8ea-86fe4dc4e557",
        "display": "Triglyceride [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b59a-4dc86f92d35b",
        "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-2c19-882ee79b8e96",
        "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b48d-d0601474ba5c",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-b48d-d0601474ba5c",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69737-5",
          "display": "Generalized anxiety disorder 7 item (GAD-7)"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T15:46:23+00:00",
      "issued": "2018-05-26T15:46:23.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-4896-fcf6a88d5203",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f028-5d02037e9495",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-f028-5d02037e9495",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55757-9",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T16:29:08+00:00",
      "issued": "2018-05-26T16:29:08.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-d2e1-257de9a012e3",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8447-e199fd0d1ce9",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-8447-e199fd0d1ce9",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "44249-1",
          "display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
        } ],
        "text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
      },
      "effectiveDateTime": "2018-05-26T16:54:02+00:00",
      "issued": "2018-05-26T16:54:02.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-ff47-a4f2ffdf6603",
        "display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f67e-c9f5b85d6f81",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-f67e-c9f5b85d6f81",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2018-05-26T14:42:27+00:00",
        "end": "2018-05-26T15:23:17+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-aced-1f2bc6de0cb3"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9649-8d7325226ab9"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-7421-f4b2cf387cc5"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-29d0-b8e4854b83fe"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-149b-fc7af06de876"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c206-4dc67351fc86"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-9ccf-ee4a385e147e"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "715252007"
          } ]
        },
        "net": {
          "value": 25.88,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 2397.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:71948fb7-8b50-bdce-7a9d-8a798c31669c",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "71948fb7-8b50-bdce-7a9d-8a798c31669c",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-f67e-c9f5b85d6f81"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2018-05-26T15:23:17+00:00",
        "end": "2019-05-26T15:23:17+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "715252007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 5.176,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 20.704,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 25.88,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 25.88,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 853.36,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1917.744,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-918c-d9cb8306ce11",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-918c-d9cb8306ce11",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185345009",
          "display": "Encounter for symptom (procedure)"
        } ],
        "text": "Encounter for symptom (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2018-07-18T03:42:27+00:00",
        "end": "2018-07-18T03:57:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "444814009",
          "display": "Viral sinusitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c5da-1fec2493e463",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-c5da-1fec2493e463",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "444814009",
          "display": "Viral sinusitis (disorder)"
        } ],
        "text": "Viral sinusitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-918c-d9cb8306ce11"
      },
      "onsetDateTime": "2018-07-18T03:42:27+00:00",
      "abatementDateTime": "2018-08-05T03:42:27+00:00",
      "assertedDate": "2018-07-18T03:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4c91-cf4b3253c901",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-4c91-cf4b3253c901",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "562251",
          "display": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
        } ],
        "text": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-918c-d9cb8306ce11"
      },
      "authoredOn": "2018-07-18T03:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-c5da-1fec2493e463"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2b80-cf8c094cf7d0",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-2b80-cf8c094cf7d0",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2018-07-18T03:42:27+00:00",
        "end": "2018-07-18T03:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4c91-cf4b3253c901"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-918c-d9cb8306ce11"
        } ]
      } ],
      "total": {
        "value": 69.25,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-914e-0e03e9784c30",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-914e-0e03e9784c30",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2018-07-18T03:42:27+00:00",
        "end": "2018-07-18T03:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c5da-1fec2493e463"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-918c-d9cb8306ce11"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:d6a5c808-0514-3491-46ee-1021ba4e59d8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "d6a5c808-0514-3491-46ee-1021ba4e59d8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-914e-0e03e9784c30"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2018-07-18T03:57:27+00:00",
        "end": "2019-07-18T03:57:27+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c5da-1fec2493e463"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4a6c-cd1e0889ee9b",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-4a6c-cd1e0889ee9b",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185349003",
          "display": "Encounter for check up (procedure)"
        } ],
        "text": "Encounter for check up (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2019-04-11T15:37:45+00:00",
        "end": "2019-04-11T16:20:20+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "275978004",
          "display": "Screening for malignant neoplasm of colon (procedure)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-114a-0c0c36d8b28c",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-114a-0c0c36d8b28c",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73761001",
          "display": "Colonoscopy (procedure)"
        } ],
        "text": "Colonoscopy (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-4a6c-cd1e0889ee9b"
      },
      "performedPeriod": {
        "start": "2019-04-11T15:37:45+00:00",
        "end": "2019-04-11T16:20:20+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b287-665dbd313a05",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-b287-665dbd313a05",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2019-04-11T15:37:45+00:00",
        "end": "2019-04-11T16:20:20+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-114a-0c0c36d8b28c"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-4a6c-cd1e0889ee9b"
        } ]
      }, {
        "sequence": 2,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "73761001"
          } ]
        },
        "net": {
          "value": 14771.85,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 14857.40,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:eb31ecf6-87a4-f8c1-b6ab-f72a09e74452",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "eb31ecf6-87a4-f8c1-b6ab-f72a09e74452",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-b287-665dbd313a05"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2019-04-11T16:20:20+00:00",
        "end": "2020-04-11T16:20:20+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "73761001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 2954.3700000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 11817.480000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 14771.85,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 14771.85,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 14857.40,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 11885.920000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-9cee-993f745ca7e8",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2019-06-01T14:42:27+00:00",
        "end": "2019-06-01T15:22:55+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a71a-1504beec899e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a71a-1504beec899e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.0600,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fb33-9c996d811a71",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-fb33-9c996d811a71",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7c12-b73952a95fe8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7c12-b73952a95fe8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e463-683b4f71f6d8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e463-683b4f71f6d8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b6d5-7da2c5a93e9a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b6d5-7da2c5a93e9a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4b24-1afade168575",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4b24-1afade168575",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 73,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 110,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f0e2-130a584797e7",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f0e2-130a584797e7",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 99,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1d43-82e97881bb2c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1d43-82e97881bb2c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-afa8-ea1d39b6830e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-afa8-ea1d39b6830e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 76.800,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ce0b-a3e286fb0f25",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ce0b-a3e286fb0f25",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 18.780,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-356c-df8c0de6e0cc",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-356c-df8c0de6e0cc",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1.0600,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7cea-26e6446cc896",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7cea-26e6446cc896",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.6500,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f564-80959166bf5d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f564-80959166bf5d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 139.60,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-69c0-f2416c9884b3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-69c0-f2416c9884b3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 3.7800,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-812f-ccc7abff25cb",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-812f-ccc7abff25cb",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 104.78,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4e80-dcd933a01b04",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4e80-dcd933a01b04",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 23.170,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6b4c-376ffabd2758",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6b4c-376ffabd2758",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5fb0-fa430ed56911",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-5fb0-fa430ed56911",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T15:22:55+00:00",
      "issued": "2019-06-01T15:22:55.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA6568-5",
            "display": "Not at all"
          } ],
          "text": "Not at all"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30132-7",
            "display": "5 or more times a week"
          } ],
          "text": "5 or more times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2674-cba4beeb6e3e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2674-cba4beeb6e3e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "70274-6",
          "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T15:42:57+00:00",
      "issued": "2019-06-01T15:42:57.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b6bf-061ec505212f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b6bf-061ec505212f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55758-7",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T16:20:43+00:00",
      "issued": "2019-06-01T16:20:43.042+00:00",
      "valueQuantity": {
        "value": 6,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-09a7-d7062be518b0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-09a7-d7062be518b0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "44261-6",
          "display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T16:50:20+00:00",
      "issued": "2019-06-01T16:50:20.042+00:00",
      "valueQuantity": {
        "value": 13,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3909-ffb4a0a7c2a8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3909-ffb4a0a7c2a8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "82667-7",
          "display": "Total score [DAST-10]"
        } ],
        "text": "Total score [DAST-10]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T17:30:08+00:00",
      "issued": "2019-06-01T17:30:08.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8233-0309cfe565a4",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-8233-0309cfe565a4",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T14:42:27+00:00",
        "end": "2019-06-01T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-79e1-7e798d9ca2bc",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-79e1-7e798d9ca2bc",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T14:42:27+00:00",
        "end": "2019-06-01T15:22:55+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fc6e-1d045f420e8d",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-fc6e-1d045f420e8d",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710841007",
          "display": "Assessment of anxiety (procedure)"
        } ],
        "text": "Assessment of anxiety (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T15:22:55+00:00",
        "end": "2019-06-01T15:42:57+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4342-ed973f5cecf2",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-4342-ed973f5cecf2",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T15:42:57+00:00",
        "end": "2019-06-01T15:56:40+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-23de-02504418e020",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-23de-02504418e020",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T15:56:40+00:00",
        "end": "2019-06-01T16:20:43+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7f17-8c710dd0af97",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-7f17-8c710dd0af97",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "715252007",
          "display": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
        } ],
        "text": "Depression screening using Patient Health Questionnaire Nine Item score (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T16:20:43+00:00",
        "end": "2019-06-01T16:50:20+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1fee-d735da9b47b6",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-1fee-d735da9b47b6",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T16:50:20+00:00",
        "end": "2019-06-01T17:02:16+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cdb6-c2c5f9da04ff",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-cdb6-c2c5f9da04ff",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "713106006",
          "display": "Screening for drug abuse (procedure)"
        } ],
        "text": "Screening for drug abuse (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "performedPeriod": {
        "start": "2019-06-01T17:02:16+00:00",
        "end": "2019-06-01T17:30:08+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8c73-4b8a748e115f",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-8c73-4b8a748e115f",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "authoredOn": "2019-06-01T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2712-0fa064797569",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-2712-0fa064797569",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2019-06-01T14:42:27+00:00",
        "end": "2019-06-01T15:22:55+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8c73-4b8a748e115f"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7bd1-7b56b07511de",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-7bd1-7b56b07511de",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "authoredOn": "2019-06-01T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-04e8-f904946a77ee",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-04e8-f904946a77ee",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2019-06-01T14:42:27+00:00",
        "end": "2019-06-01T15:22:55+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-7bd1-7b56b07511de"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
        } ]
      } ],
      "total": {
        "value": 1.37,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8083-0435552ecbba",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-8083-0435552ecbba",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "date": "2019-06-01T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-560d-64a1cf7047c7",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-560d-64a1cf7047c7",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T14:42:27+00:00",
      "issued": "2019-06-01T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-afa8-ea1d39b6830e",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-ce0b-a3e286fb0f25",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-356c-df8c0de6e0cc",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-7cea-26e6446cc896",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f564-80959166bf5d",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-69c0-f2416c9884b3",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-812f-ccc7abff25cb",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-4e80-dcd933a01b04",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1f22-bb448b1606ad",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-1f22-bb448b1606ad",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69737-5",
          "display": "Generalized anxiety disorder 7 item (GAD-7)"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T15:42:57+00:00",
      "issued": "2019-06-01T15:42:57.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-2674-cba4beeb6e3e",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-574d-fce5dea457b6",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-574d-fce5dea457b6",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55757-9",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T16:20:43+00:00",
      "issued": "2019-06-01T16:20:43.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-b6bf-061ec505212f",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6361-cdbda2a25b32",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-6361-cdbda2a25b32",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "44249-1",
          "display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
        } ],
        "text": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T16:50:20+00:00",
      "issued": "2019-06-01T16:50:20.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-09a7-d7062be518b0",
        "display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c6ea-0164a0c52db1",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-c6ea-0164a0c52db1",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "82666-9",
          "display": "Drug Abuse Screening Test-10 [DAST-10]"
        } ],
        "text": "Drug Abuse Screening Test-10 [DAST-10]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
      },
      "effectiveDateTime": "2019-06-01T17:30:08+00:00",
      "issued": "2019-06-01T17:30:08.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-3909-ffb4a0a7c2a8",
        "display": "Total score [DAST-10]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dfab-7c430623378e",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-dfab-7c430623378e",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 100
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "1137596000",
            "display": "Blood lancet (physical object)"
          } ],
          "text": "Blood lancet (physical object)"
        }
      },
      "occurrenceDateTime": "2019-06-01T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3962-6e2761406343",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-3962-6e2761406343",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2019-06-01T14:42:27+00:00",
        "end": "2019-06-01T15:22:55+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-8083-0435552ecbba"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 7,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-8233-0309cfe565a4"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-79e1-7e798d9ca2bc"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-fc6e-1d045f420e8d"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-4342-ed973f5cecf2"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-23de-02504418e020"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-7f17-8c710dd0af97"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-1fee-d735da9b47b6"
        }
      }, {
        "sequence": 8,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-cdb6-c2c5f9da04ff"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-9cee-993f745ca7e8"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 359.47,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 6 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "715252007"
          } ]
        },
        "net": {
          "value": 25.88,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "procedureLinkId": [ 7 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "procedureLinkId": [ 8 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "713106006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 16,
        "informationLinkId": [ 7 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3619.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:552f305f-4600-46e6-8ba5-ebdfeece4fef",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "552f305f-4600-46e6-8ba5-ebdfeece4fef",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-3962-6e2761406343"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2019-06-01T15:22:55+00:00",
        "end": "2020-06-01T15:22:55+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 71.894,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 287.576,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 359.47,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 359.47,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "715252007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 5.176,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 20.704,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 25.88,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 25.88,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "713106006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 16,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1138.25,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2895.5600000000004,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-e940-7e113b43f254",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2020-06-06T14:42:27+00:00",
        "end": "2020-06-06T15:33:10+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-357c-4d867a372931",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-357c-4d867a372931",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "onsetDateTime": "2020-06-06T14:42:27+00:00",
      "abatementDateTime": "2020-06-06T14:42:27+00:00",
      "assertedDate": "2020-06-06T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ad3a-481c493641a8",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-ad3a-481c493641a8",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "423315002",
          "display": "Limited social contact (finding)"
        } ],
        "text": "Limited social contact (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "onsetDateTime": "2020-06-06T15:33:10+00:00",
      "abatementDateTime": "2026-07-11T15:12:47+00:00",
      "assertedDate": "2020-06-06T15:33:10+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9f03-1ae3a4a25c52",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-9f03-1ae3a4a25c52",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73595000",
          "display": "Stress (finding)"
        } ],
        "text": "Stress (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "onsetDateTime": "2020-06-06T15:33:10+00:00",
      "abatementDateTime": "2022-06-18T15:20:14+00:00",
      "assertedDate": "2020-06-06T15:33:10+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2f8f-7099649d8e6d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2f8f-7099649d8e6d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 5.9000,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c98a-a7bcd35f3bce",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c98a-a7bcd35f3bce",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8d09-244d7e66ecda",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-8d09-244d7e66ecda",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 4,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-06de-0b6b3417490a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-06de-0b6b3417490a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a100-4ac65e774941",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a100-4ac65e774941",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a956-ca8ccc987e35",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a956-ca8ccc987e35",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 71,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 111,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7331-9f8e412cb08d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7331-9f8e412cb08d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 98,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-778f-3e3e66a85393",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-778f-3e3e66a85393",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 16,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dc98-b4f58be92b3a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-dc98-b4f58be92b3a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 73.800,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-890b-720c6eefec93",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-890b-720c6eefec93",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 17.740,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ef83-42cb55dff7cf",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ef83-42cb55dff7cf",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0.99000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1509-fb1948c1944d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1509-fb1948c1944d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.0500,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d6fb-ab6f268124d7",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d6fb-ab6f268124d7",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 139.73,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9c08-89b18e0211ff",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9c08-89b18e0211ff",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 5.0800,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9441-d8b165c45eb6",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9441-d8b165c45eb6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 104.86,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-947b-b349b4b89b90",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-947b-b349b4b89b90",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 21.430,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ffbb-9b4492f12fd3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ffbb-9b4492f12fd3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6946-5a0f7a4370ad",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6946-5a0f7a4370ad",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T15:33:10+00:00",
      "issued": "2020-06-06T15:33:10.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA13863-8",
            "display": "A little bit"
          } ],
          "text": "A little bit"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30130-1",
            "display": "1 or 2 times a week"
          } ],
          "text": "1 or 2 times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-55a7-a65baaf03def",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-55a7-a65baaf03def",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "70274-6",
          "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T15:49:01+00:00",
      "issued": "2020-06-06T15:49:01.042+00:00",
      "valueQuantity": {
        "value": 10,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-02de-26c21dc29c97",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-02de-26c21dc29c97",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "75626-2",
          "display": "Total score [AUDIT-C]"
        } ],
        "text": "Total score [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T16:22:52+00:00",
      "issued": "2020-06-06T16:22:52.042+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d018-7fe745283a77",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-d018-7fe745283a77",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "performedPeriod": {
        "start": "2020-06-06T14:42:27+00:00",
        "end": "2020-06-06T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6fcd-1300919f2405",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-6fcd-1300919f2405",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "performedPeriod": {
        "start": "2020-06-06T14:42:27+00:00",
        "end": "2020-06-06T15:33:10+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0a24-4635672c61d0",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-0a24-4635672c61d0",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710841007",
          "display": "Assessment of anxiety (procedure)"
        } ],
        "text": "Assessment of anxiety (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "performedPeriod": {
        "start": "2020-06-06T15:33:10+00:00",
        "end": "2020-06-06T15:49:01+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-08eb-9a367c01c63b",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-08eb-9a367c01c63b",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "performedPeriod": {
        "start": "2020-06-06T15:49:01+00:00",
        "end": "2020-06-06T16:02:23+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0e39-6f4ea183b0cc",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-0e39-6f4ea183b0cc",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "763302001",
          "display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
        } ],
        "text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "performedPeriod": {
        "start": "2020-06-06T16:02:23+00:00",
        "end": "2020-06-06T16:22:52+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6478-523ce37ca669",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-6478-523ce37ca669",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "authoredOn": "2020-06-06T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3eed-469eef2215a5",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-3eed-469eef2215a5",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2020-06-06T14:42:27+00:00",
        "end": "2020-06-06T15:33:10+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-6478-523ce37ca669"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
        } ]
      } ],
      "total": {
        "value": 0.61,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0b21-15c681f34b64",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-0b21-15c681f34b64",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "authoredOn": "2020-06-06T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2ca5-5ee1102685cf",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-2ca5-5ee1102685cf",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2020-06-06T14:42:27+00:00",
        "end": "2020-06-06T15:33:10+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-0b21-15c681f34b64"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
        } ]
      } ],
      "total": {
        "value": 1.37,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-22e4-f620ec3ce29e",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-22e4-f620ec3ce29e",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "date": "2020-06-06T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2079-69b1dd3f872b",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-2079-69b1dd3f872b",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "113",
          "display": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
        } ],
        "text": "Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "date": "2020-06-06T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fd44-fb88ea2b4756",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-fd44-fb88ea2b4756",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T14:42:27+00:00",
      "issued": "2020-06-06T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-dc98-b4f58be92b3a",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-890b-720c6eefec93",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-ef83-42cb55dff7cf",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-1509-fb1948c1944d",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-d6fb-ab6f268124d7",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9c08-89b18e0211ff",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9441-d8b165c45eb6",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-947b-b349b4b89b90",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-26c5-27a48b4ba4e1",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-26c5-27a48b4ba4e1",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69737-5",
          "display": "Generalized anxiety disorder 7 item (GAD-7)"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T15:49:01+00:00",
      "issued": "2020-06-06T15:49:01.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-55a7-a65baaf03def",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-22a1-7cd7cae482ca",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-22a1-7cd7cae482ca",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72109-2",
          "display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
        } ],
        "text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
      },
      "effectiveDateTime": "2020-06-06T16:22:52+00:00",
      "issued": "2020-06-06T16:22:52.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-02de-26c21dc29c97",
        "display": "Total score [AUDIT-C]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8172-6e82c03364c8",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-8172-6e82c03364c8",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2020-06-06T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-75c9-6551b127e7bc",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-75c9-6551b127e7bc",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 100
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "1137596000",
            "display": "Blood lancet (physical object)"
          } ],
          "text": "Blood lancet (physical object)"
        }
      },
      "occurrenceDateTime": "2020-06-06T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-eb16-be0b096d9d3c",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-eb16-be0b096d9d3c",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2020-06-06T14:42:27+00:00",
        "end": "2020-06-06T15:33:10+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-22e4-f620ec3ce29e"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-2079-69b1dd3f872b"
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 7,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-357c-4d867a372931"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ad3a-481c493641a8"
        }
      }, {
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9f03-1ae3a4a25c52"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-d018-7fe745283a77"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6fcd-1300919f2405"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0a24-4635672c61d0"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-08eb-9a367c01c63b"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0e39-6f4ea183b0cc"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-e940-7e113b43f254"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 5,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 586.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 11,
        "diagnosisLinkId": [ 3 ]
      }, {
        "sequence": 12,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 16,
        "informationLinkId": [ 7 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 2951.38,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:eeea2c65-3e03-3eca-6115-a285e6d147d4",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "eeea2c65-3e03-3eca-6115-a285e6d147d4",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-eb16-be0b096d9d3c"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2020-06-06T15:33:10+00:00",
        "end": "2021-06-06T15:33:10+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-357c-4d867a372931"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ad3a-481c493641a8"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9f03-1ae3a4a25c52"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 117.28800000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 469.15200000000004,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 586.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 586.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 16,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1508.02,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2361.1040000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-aab8-c6619aacf257",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-aab8-c6619aacf257",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "33879002",
          "display": "Administration of vaccine to produce active immunity (procedure)"
        } ],
        "text": "Administration of vaccine to produce active immunity (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2021-03-06T14:42:27+00:00",
        "end": "2021-03-06T14:57:27+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-333d-ba014e2bc999",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-333d-ba014e2bc999",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "208",
          "display": "COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose"
        } ],
        "text": "COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-aab8-c6619aacf257"
      },
      "date": "2021-03-06T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8e3e-0c5c62b1a901",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-8e3e-0c5c62b1a901",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-03-06T14:42:27+00:00",
        "end": "2021-03-06T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-333d-ba014e2bc999"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-aab8-c6619aacf257"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 278.58,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:9259e2f3-8741-9734-e3f5-f506c3770535",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "9259e2f3-8741-9734-e3f5-f506c3770535",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999988196"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-8e3e-0c5c62b1a901"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-03-06T14:57:27+00:00",
        "end": "2022-03-06T14:57:27+00:00"
      },
      "created": "2021-03-06T14:57:27+00:00",
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8e3e-0c5c62b1a901"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2021-03-06T14:42:27+00:00",
          "end": "2021-03-06T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-aab8-c6619aacf257"
        } ],
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 28.516000000000005,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 114.06400000000002,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 142.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 142.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2021-03-06T14:42:27+00:00",
          "end": "2021-03-06T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 278.58,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 222.86400000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3115-0dd8148dcc03",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-3115-0dd8148dcc03",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "33879002",
          "display": "Administration of vaccine to produce active immunity (procedure)"
        } ],
        "text": "Administration of vaccine to produce active immunity (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2021-03-27T14:42:27+00:00",
        "end": "2021-03-27T14:57:27+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b972-16f9f13ef0e3",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-b972-16f9f13ef0e3",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "208",
          "display": "COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose"
        } ],
        "text": "COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-3115-0dd8148dcc03"
      },
      "date": "2021-03-27T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-00f5-7b73e41c5c33",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-00f5-7b73e41c5c33",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-03-27T14:42:27+00:00",
        "end": "2021-03-27T14:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-b972-16f9f13ef0e3"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-3115-0dd8148dcc03"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 278.58,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:54865003-5614-0901-f7be-7429dc039683",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "54865003-5614-0901-f7be-7429dc039683",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999988196"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-00f5-7b73e41c5c33"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-03-27T14:57:27+00:00",
        "end": "2022-03-27T14:57:27+00:00"
      },
      "created": "2021-03-27T14:57:27+00:00",
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:e63ee044-44a6-784d-00f5-7b73e41c5c33"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2021-03-27T14:42:27+00:00",
          "end": "2021-03-27T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-3115-0dd8148dcc03"
        } ],
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 28.516000000000005,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 114.06400000000002,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 142.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 142.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2021-03-27T14:42:27+00:00",
          "end": "2021-03-27T14:57:27+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 278.58,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 222.86400000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-093c-d8331e6bff6f",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2021-06-12T14:42:27+00:00",
        "end": "2021-06-12T15:15:54+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-46c8-0abacf56d9b0",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-46c8-0abacf56d9b0",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "onsetDateTime": "2021-06-12T14:42:27+00:00",
      "abatementDateTime": "2022-06-18T14:42:27+00:00",
      "assertedDate": "2021-06-12T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f5c3-62c061b47f9f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f5c3-62c061b47f9f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.1400,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8d93-84b5974011a2",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-8d93-84b5974011a2",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-afbb-0e5cac669db0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-afbb-0e5cac669db0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dae5-f72c0e6cbdfb",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-dae5-f72c0e6cbdfb",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8792-6fb7970aaed3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-8792-6fb7970aaed3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c50f-423b066b83e3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c50f-423b066b83e3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 73,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 105,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6dd3-c88f20ae0fe1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6dd3-c88f20ae0fe1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 82,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8143-ee6c5f122e2f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-8143-ee6c5f122e2f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 13,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3e30-6e4c82a41e12",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3e30-6e4c82a41e12",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 85.940,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b82f-dc64ca3fc18a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b82f-dc64ca3fc18a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 11.920,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a670-7f2d00458390",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a670-7f2d00458390",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1.0900,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3644-e71292531e05",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3644-e71292531e05",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.3700,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f777-0c2c65d45417",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f777-0c2c65d45417",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 143.58,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-10a4-6c4ddd932f56",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-10a4-6c4ddd932f56",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 4.4200,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-54af-6e3b3b0feb07",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-54af-6e3b3b0feb07",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 107.53,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-58fc-c2c6ac6db87c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-58fc-c2c6ac6db87c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 23.580,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1e4d-8390c4c738f2",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1e4d-8390c4c738f2",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2093-3",
          "display": "Cholesterol [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Cholesterol [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 166.88,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-81f1-c496940f4b99",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-81f1-c496940f4b99",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2571-8",
          "display": "Triglyceride [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Triglyceride [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 108.92,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4fe8-67e289477122",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4fe8-67e289477122",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "18262-6",
          "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
        } ],
        "text": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 114.19,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-30a8-55c33b572e2b",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-30a8-55c33b572e2b",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2085-9",
          "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 30.910,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c83f-c1060eeba477",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c83f-c1060eeba477",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6690-2",
          "display": "Leukocytes [#/volume] in Blood by Automated count"
        } ],
        "text": "Leukocytes [#/volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.8860,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b730-405dad5d92af",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b730-405dad5d92af",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "789-8",
          "display": "Erythrocytes [#/volume] in Blood by Automated count"
        } ],
        "text": "Erythrocytes [#/volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 4.1547,
        "unit": "10*6/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*6/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8ed0-8193353c426f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-8ed0-8193353c426f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "718-7",
          "display": "Hemoglobin [Mass/volume] in Blood"
        } ],
        "text": "Hemoglobin [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 13.011,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-668f-39cddfc87959",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-668f-39cddfc87959",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4544-3",
          "display": "Hematocrit [Volume Fraction] of Blood by Automated count"
        } ],
        "text": "Hematocrit [Volume Fraction] of Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 36.053,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4abc-fa31e21d48f4",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4abc-fa31e21d48f4",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "787-2",
          "display": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
        } ],
        "text": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 84.852,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2c67-8b64777e9de6",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2c67-8b64777e9de6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "785-6",
          "display": "MCH [Entitic mass] by Automated count"
        } ],
        "text": "MCH [Entitic mass] by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 30.415,
        "unit": "pg",
        "system": "http://unitsofmeasure.org",
        "code": "pg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4c90-fd4c80a50e62",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4c90-fd4c80a50e62",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "786-4",
          "display": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
        } ],
        "text": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 34.894,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9b61-6f1da1539bdf",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9b61-6f1da1539bdf",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "788-0",
          "display": "Erythrocyte [DistWidth] in Blood by Automated count"
        } ],
        "text": "Erythrocyte [DistWidth] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 41.686,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c05e-d393c11b5c0a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c05e-d393c11b5c0a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "777-3",
          "display": "Platelets [#/volume] in Blood by Automated count"
        } ],
        "text": "Platelets [#/volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 316.74,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-afa6-357ca9fc3cfc",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-afa6-357ca9fc3cfc",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "32207-3",
          "display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
        } ],
        "text": "Platelet distribution width [Entitic volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 14.563,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f5d6-407a1ed158af",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f5d6-407a1ed158af",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "32623-1",
          "display": "Platelet [Entitic mean volume] in Blood by Automated count"
        } ],
        "text": "Platelet [Entitic mean volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.7363,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6913-1204cf6a8bae",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6913-1204cf6a8bae",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d5aa-c15223e430bc",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d5aa-c15223e430bc",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T15:15:54+00:00",
      "issued": "2021-06-12T15:15:54.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA13863-8",
            "display": "A little bit"
          } ],
          "text": "A little bit"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30131-9",
            "display": "3 to 5 times a week"
          } ],
          "text": "3 to 5 times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dc8e-9522f0ff13fd",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-dc8e-9522f0ff13fd",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "76504-0",
          "display": "Total score [HARK]"
        } ],
        "text": "Total score [HARK]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T15:55:07+00:00",
      "issued": "2021-06-12T15:55:07.042+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-90a6-9bec86c3d47e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-90a6-9bec86c3d47e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "82667-7",
          "display": "Total score [DAST-10]"
        } ],
        "text": "Total score [DAST-10]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T16:34:06+00:00",
      "issued": "2021-06-12T16:34:06.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d206-6507efcb35f0",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-d206-6507efcb35f0",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "performedPeriod": {
        "start": "2021-06-12T14:42:27+00:00",
        "end": "2021-06-12T15:15:54+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-de8d-1896930143a7",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-de8d-1896930143a7",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "866148006",
          "display": "Screening for domestic abuse (procedure)"
        } ],
        "text": "Screening for domestic abuse (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "performedPeriod": {
        "start": "2021-06-12T15:15:54+00:00",
        "end": "2021-06-12T15:55:07+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-517e-182500b73f70",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-517e-182500b73f70",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "performedPeriod": {
        "start": "2021-06-12T15:55:07+00:00",
        "end": "2021-06-12T16:10:03+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-49e3-fb29d6b23c9a",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-49e3-fb29d6b23c9a",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "713106006",
          "display": "Screening for drug abuse (procedure)"
        } ],
        "text": "Screening for drug abuse (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "performedPeriod": {
        "start": "2021-06-12T16:10:03+00:00",
        "end": "2021-06-12T16:34:06+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9bec-3cc0d865ae18",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-9bec-3cc0d865ae18",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "authoredOn": "2021-06-12T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5ad6-c717ff851769",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-5ad6-c717ff851769",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-06-12T14:42:27+00:00",
        "end": "2021-06-12T15:15:54+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9bec-3cc0d865ae18"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8aa4-80ad69d00dc7",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-8aa4-80ad69d00dc7",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "authoredOn": "2021-06-12T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7c7c-2252c52703a5",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-7c7c-2252c52703a5",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-06-12T14:42:27+00:00",
        "end": "2021-06-12T15:15:54+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8aa4-80ad69d00dc7"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
        } ]
      } ],
      "total": {
        "value": 1.37,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ba52-bdd4a67b2f5b",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-ba52-bdd4a67b2f5b",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "date": "2021-06-12T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-28a7-ab1dd9c6b87a",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-28a7-ab1dd9c6b87a",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-3e30-6e4c82a41e12",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b82f-dc64ca3fc18a",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-a670-7f2d00458390",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-3644-e71292531e05",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f777-0c2c65d45417",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-10a4-6c4ddd932f56",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-54af-6e3b3b0feb07",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-58fc-c2c6ac6db87c",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5c7b-bf1c5a853a17",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-5c7b-bf1c5a853a17",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "57698-3",
          "display": "Lipid panel with direct LDL - Serum or Plasma"
        } ],
        "text": "Lipid panel with direct LDL - Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-1e4d-8390c4c738f2",
        "display": "Cholesterol [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-81f1-c496940f4b99",
        "display": "Triglyceride [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-4fe8-67e289477122",
        "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-30a8-55c33b572e2b",
        "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4b81-0f7db370846c",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-4b81-0f7db370846c",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "58410-2",
          "display": "CBC panel - Blood by Automated count"
        } ],
        "text": "CBC panel - Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T14:42:27+00:00",
      "issued": "2021-06-12T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-c83f-c1060eeba477",
        "display": "Leukocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b730-405dad5d92af",
        "display": "Erythrocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-8ed0-8193353c426f",
        "display": "Hemoglobin [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-668f-39cddfc87959",
        "display": "Hematocrit [Volume Fraction] of Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-4abc-fa31e21d48f4",
        "display": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-2c67-8b64777e9de6",
        "display": "MCH [Entitic mass] by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-4c90-fd4c80a50e62",
        "display": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9b61-6f1da1539bdf",
        "display": "Erythrocyte [DistWidth] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-c05e-d393c11b5c0a",
        "display": "Platelets [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-afa6-357ca9fc3cfc",
        "display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f5d6-407a1ed158af",
        "display": "Platelet [Entitic mean volume] in Blood by Automated count"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-35c4-367ee1c0ff41",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-35c4-367ee1c0ff41",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "76499-3",
          "display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
        } ],
        "text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T15:55:07+00:00",
      "issued": "2021-06-12T15:55:07.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-dc8e-9522f0ff13fd",
        "display": "Total score [HARK]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6f35-48a068d26fb9",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-6f35-48a068d26fb9",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "82666-9",
          "display": "Drug Abuse Screening Test-10 [DAST-10]"
        } ],
        "text": "Drug Abuse Screening Test-10 [DAST-10]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
      },
      "effectiveDateTime": "2021-06-12T16:34:06+00:00",
      "issued": "2021-06-12T16:34:06.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-90a6-9bec86c3d47e",
        "display": "Total score [DAST-10]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-af1d-317c9277deb4",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-af1d-317c9277deb4",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2021-06-12T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2059-c58a64def0c0",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-2059-c58a64def0c0",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2021-06-12T14:42:27+00:00",
        "end": "2021-06-12T15:15:54+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ba52-bdd4a67b2f5b"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 7,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-46c8-0abacf56d9b0"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-d206-6507efcb35f0"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-de8d-1896930143a7"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-517e-182500b73f70"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-49e3-fb29d6b23c9a"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-093c-d8331e6bff6f"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 4,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "866148006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "713106006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "informationLinkId": [ 7 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 2378.10,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:3cad3d55-46fb-c251-74d1-640cc7bec4f4",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "3cad3d55-46fb-c251-74d1-640cc7bec4f4",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-2059-c58a64def0c0"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2021-06-12T15:15:54+00:00",
        "end": "2022-06-12T15:15:54+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-46c8-0abacf56d9b0"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "866148006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "713106006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 934.74,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1902.4799999999998,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0f1c-97b70bb9c7ba",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-0f1c-97b70bb9c7ba",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185345009",
          "display": "Encounter for symptom (procedure)"
        } ],
        "text": "Encounter for symptom (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2022-05-23T02:42:27+00:00",
        "end": "2022-05-23T02:57:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "444814009",
          "display": "Viral sinusitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a4c4-e737451a2ad2",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-a4c4-e737451a2ad2",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "444814009",
          "display": "Viral sinusitis (disorder)"
        } ],
        "text": "Viral sinusitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-0f1c-97b70bb9c7ba"
      },
      "onsetDateTime": "2022-05-23T02:42:27+00:00",
      "abatementDateTime": "2022-06-02T02:42:27+00:00",
      "assertedDate": "2022-05-23T02:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ce9a-788b150f737c",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-ce9a-788b150f737c",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "562251",
          "display": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
        } ],
        "text": "Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-0f1c-97b70bb9c7ba"
      },
      "authoredOn": "2022-05-23T02:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-c5da-1fec2493e463"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-a4c4-e737451a2ad2"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-374b-fe04fbc0aa85",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-374b-fe04fbc0aa85",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2022-05-23T02:42:27+00:00",
        "end": "2022-05-23T02:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ce9a-788b150f737c"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-0f1c-97b70bb9c7ba"
        } ]
      } ],
      "total": {
        "value": 367.86,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4abb-5268741517d5",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-4abb-5268741517d5",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2022-05-23T02:42:27+00:00",
        "end": "2022-05-23T02:57:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-a4c4-e737451a2ad2"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-0f1c-97b70bb9c7ba"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:b68930ad-ec5c-27d2-60ae-16c2061d490f",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "b68930ad-ec5c-27d2-60ae-16c2061d490f",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-4abb-5268741517d5"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2022-05-23T02:57:27+00:00",
        "end": "2023-05-23T02:57:27+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-a4c4-e737451a2ad2"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 68.44,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-26dd-a31b5a4c2399",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2022-06-18T14:42:27+00:00",
        "end": "2022-06-18T15:20:14+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5bff-4d65d4ac2619",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-5bff-4d65d4ac2619",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.1100,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cf15-64e8400d5453",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-cf15-64e8400d5453",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-aa4f-17899210ff6a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-aa4f-17899210ff6a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1503-f16f7bc50985",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1503-f16f7bc50985",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c15e-d910022e7b3c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c15e-d910022e7b3c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-370c-e8a1c51608b3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-370c-e8a1c51608b3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 71,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 97,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-55e0-3f6cd20e1505",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-55e0-3f6cd20e1505",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 82,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-388f-c00e9465d0a4",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-388f-c00e9465d0a4",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-000d-5b5abd787006",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-000d-5b5abd787006",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 71.330,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2a86-68e84d923240",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2a86-68e84d923240",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 18.230,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7e8a-944fed38016a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7e8a-944fed38016a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0.90000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f017-d0a44e0e7c57",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f017-d0a44e0e7c57",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 10.110,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-961f-4ef4bfea2ec1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-961f-4ef4bfea2ec1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 140.53,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1f2c-5abe76746978",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1f2c-5abe76746978",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 4.3400,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e04c-a2fdece59b4f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e04c-a2fdece59b4f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 104.91,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-906d-553645792cdc",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-906d-553645792cdc",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 26.770,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-992e-72b81542cbbb",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-992e-72b81542cbbb",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b1f5-f85f2b37f6f5",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b1f5-f85f2b37f6f5",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T15:20:14+00:00",
      "issued": "2022-06-18T15:20:14.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA6568-5",
            "display": "Not at all"
          } ],
          "text": "Not at all"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30132-7",
            "display": "5 or more times a week"
          } ],
          "text": "5 or more times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4495-087635cc6bee",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4495-087635cc6bee",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "70274-6",
          "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T15:39:57+00:00",
      "issued": "2022-06-18T15:39:57.042+00:00",
      "valueQuantity": {
        "value": 3,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a5a0-bacccc6d437c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a5a0-bacccc6d437c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55758-7",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T16:17:06+00:00",
      "issued": "2022-06-18T16:17:06.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6e8b-b6e644e24d49",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-6e8b-b6e644e24d49",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "performedPeriod": {
        "start": "2022-06-18T14:42:27+00:00",
        "end": "2022-06-18T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b7a5-24a81e512c39",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-b7a5-24a81e512c39",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "performedPeriod": {
        "start": "2022-06-18T14:42:27+00:00",
        "end": "2022-06-18T15:20:14+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bdbb-6e082679df9e",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-bdbb-6e082679df9e",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710841007",
          "display": "Assessment of anxiety (procedure)"
        } ],
        "text": "Assessment of anxiety (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "performedPeriod": {
        "start": "2022-06-18T15:20:14+00:00",
        "end": "2022-06-18T15:39:57+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f4c6-4441fbdab1d9",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-f4c6-4441fbdab1d9",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "performedPeriod": {
        "start": "2022-06-18T15:39:57+00:00",
        "end": "2022-06-18T15:50:23+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fe10-5e5c8e901a55",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-fe10-5e5c8e901a55",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "performedPeriod": {
        "start": "2022-06-18T15:50:23+00:00",
        "end": "2022-06-18T16:17:06+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9d1c-5142b2429bd5",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-9d1c-5142b2429bd5",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "authoredOn": "2022-06-18T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bdc7-6d44ae2286e0",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-bdc7-6d44ae2286e0",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2022-06-18T14:42:27+00:00",
        "end": "2022-06-18T15:20:14+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9d1c-5142b2429bd5"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ebba-f604da15177a",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-ebba-f604da15177a",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "authoredOn": "2022-06-18T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4565-81ea00f7552f",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-4565-81ea00f7552f",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2022-06-18T14:42:27+00:00",
        "end": "2022-06-18T15:20:14+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebba-f604da15177a"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0489-f1c1dace6489",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-0489-f1c1dace6489",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "date": "2022-06-18T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3835-17b157f40447",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-3835-17b157f40447",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T14:42:27+00:00",
      "issued": "2022-06-18T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-000d-5b5abd787006",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-2a86-68e84d923240",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-7e8a-944fed38016a",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f017-d0a44e0e7c57",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-961f-4ef4bfea2ec1",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-1f2c-5abe76746978",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-e04c-a2fdece59b4f",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-906d-553645792cdc",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9ddf-06246d08c293",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-9ddf-06246d08c293",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69737-5",
          "display": "Generalized anxiety disorder 7 item (GAD-7)"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T15:39:57+00:00",
      "issued": "2022-06-18T15:39:57.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-4495-087635cc6bee",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b4e1-40af62c3f606",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-b4e1-40af62c3f606",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55757-9",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
      },
      "effectiveDateTime": "2022-06-18T16:17:06+00:00",
      "issued": "2022-06-18T16:17:06.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-a5a0-bacccc6d437c",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6f63-050a734b1022",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-6f63-050a734b1022",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2022-06-18T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b4b1-5ef96d11702e",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-b4b1-5ef96d11702e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2022-06-18T14:42:27+00:00",
        "end": "2022-06-18T15:20:14+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0489-f1c1dace6489"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6e8b-b6e644e24d49"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-b7a5-24a81e512c39"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-bdbb-6e082679df9e"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f4c6-4441fbdab1d9"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-fe10-5e5c8e901a55"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-26dd-a31b5a4c2399"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 862.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3091.74,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7df78693-a778-bf35-02ec-510957cd263a",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "7df78693-a778-bf35-02ec-510957cd263a",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-b4b1-5ef96d11702e"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2022-06-18T15:20:14+00:00",
        "end": "2023-06-18T15:20:14+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 172.56,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 690.24,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 862.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 862.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1648.38,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2473.3920000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-ebda-4e065b5e1714",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2023-06-24T14:42:27+00:00",
        "end": "2023-06-24T15:34:26+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-547f-9b4485f85300",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-547f-9b4485f85300",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "onsetDateTime": "2023-06-24T14:42:27+00:00",
      "abatementDateTime": "2023-06-24T14:42:27+00:00",
      "assertedDate": "2023-06-24T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-91d3-defc8b2e4882",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-91d3-defc8b2e4882",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73595000",
          "display": "Stress (finding)"
        } ],
        "text": "Stress (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "onsetDateTime": "2023-06-24T15:34:26+00:00",
      "abatementDateTime": "2024-06-29T15:38:02+00:00",
      "assertedDate": "2023-06-24T15:34:26+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bd64-5e05736f63b5",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-bd64-5e05736f63b5",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.3800,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a33a-51aea42a604b",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a33a-51aea42a604b",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a4cc-628d255ceef2",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a4cc-628d255ceef2",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-71de-c7c8913d950a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-71de-c7c8913d950a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e361-e614dad405bb",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e361-e614dad405bb",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fd86-b0e1b765465c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-fd86-b0e1b765465c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 73,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 112,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fe83-b6f04e45af43",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-fe83-b6f04e45af43",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 92,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ed2e-41d45f2e26ba",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ed2e-41d45f2e26ba",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b874-159a2c993e1c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b874-159a2c993e1c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 85.160,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7968-320de9fb82e9",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7968-320de9fb82e9",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 12.210,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9b39-29639b160488",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9b39-29639b160488",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1.0600,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0c4c-2de40b577e71",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-0c4c-2de40b577e71",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 10.080,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2f2a-51ed5eb881fb",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2f2a-51ed5eb881fb",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 138.67,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f57c-1224d1666fe0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f57c-1224d1666fe0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 3.7800,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9ba6-bad25abf31f3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9ba6-bad25abf31f3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 103.79,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6e3c-74a4974d5fa4",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-6e3c-74a4974d5fa4",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 23.190,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a597-692c95e31bf2",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a597-692c95e31bf2",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4a69-d40fb1e4302e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4a69-d40fb1e4302e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T15:34:26+00:00",
      "issued": "2023-06-24T15:34:26.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA13909-9",
            "display": "Somewhat"
          } ],
          "text": "Somewhat"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30132-7",
            "display": "5 or more times a week"
          } ],
          "text": "5 or more times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30128-5",
            "display": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
          } ],
          "text": "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30194-7",
            "display": "None/uninsured"
          } ],
          "text": "None/uninsured"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-09dd-a4d0f8e4d738",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-09dd-a4d0f8e4d738",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "75626-2",
          "display": "Total score [AUDIT-C]"
        } ],
        "text": "Total score [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T16:15:24+00:00",
      "issued": "2023-06-24T16:15:24.042+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f00a-2d073c789d7c",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-f00a-2d073c789d7c",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "performedPeriod": {
        "start": "2023-06-24T14:42:27+00:00",
        "end": "2023-06-24T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9b22-5a6a903e2567",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-9b22-5a6a903e2567",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "performedPeriod": {
        "start": "2023-06-24T14:42:27+00:00",
        "end": "2023-06-24T15:34:26+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7003-ae4f8e4f9fcd",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-7003-ae4f8e4f9fcd",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "performedPeriod": {
        "start": "2023-06-24T15:34:26+00:00",
        "end": "2023-06-24T15:48:42+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6527-203ca188faff",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-6527-203ca188faff",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "763302001",
          "display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
        } ],
        "text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "performedPeriod": {
        "start": "2023-06-24T15:48:42+00:00",
        "end": "2023-06-24T16:15:24+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6144-72c42f5f887f",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-6144-72c42f5f887f",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "authoredOn": "2023-06-24T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cb71-5bdcdf3696da",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-cb71-5bdcdf3696da",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2023-06-24T14:42:27+00:00",
        "end": "2023-06-24T15:34:26+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-6144-72c42f5f887f"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6425-b2bd995c5787",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-6425-b2bd995c5787",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "authoredOn": "2023-06-24T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cef1-2ad0ffdbb172",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-cef1-2ad0ffdbb172",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2023-06-24T14:42:27+00:00",
        "end": "2023-06-24T15:34:26+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-6425-b2bd995c5787"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4ce5-85c468b199fa",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-4ce5-85c468b199fa",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "date": "2023-06-24T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e13d-9287d87c5c39",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-e13d-9287d87c5c39",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T14:42:27+00:00",
      "issued": "2023-06-24T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-b874-159a2c993e1c",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-7968-320de9fb82e9",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9b39-29639b160488",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-0c4c-2de40b577e71",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-2f2a-51ed5eb881fb",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f57c-1224d1666fe0",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9ba6-bad25abf31f3",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-6e3c-74a4974d5fa4",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5896-761a82034ed3",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-5896-761a82034ed3",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72109-2",
          "display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
        } ],
        "text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
      },
      "effectiveDateTime": "2023-06-24T16:15:24+00:00",
      "issued": "2023-06-24T16:15:24.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-09dd-a4d0f8e4d738",
        "display": "Total score [AUDIT-C]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cd60-eea67c0f9654",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-cd60-eea67c0f9654",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2023-06-24T14:42:27+00:00",
        "end": "2023-06-24T15:34:26+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-4ce5-85c468b199fa"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-547f-9b4485f85300"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-91d3-defc8b2e4882"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f00a-2d073c789d7c"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9b22-5a6a903e2567"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-7003-ae4f8e4f9fcd"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6527-203ca188faff"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-ebda-4e065b5e1714"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 4,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 215.70,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 8,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 1931.86,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:328ed772-4b55-1356-6294-1de293a63da3",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "328ed772-4b55-1356-6294-1de293a63da3",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-cd60-eea67c0f9654"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2023-06-24T15:34:26+00:00",
        "end": "2024-06-24T15:34:26+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-547f-9b4485f85300"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-91d3-defc8b2e4882"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 43.14,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 172.56,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 215.70,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 215.70,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 994.48,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1545.488,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8727-269947ebc32c",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-8727-269947ebc32c",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185349003",
          "display": "Encounter for check up (procedure)"
        } ],
        "text": "Encounter for check up (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2024-04-10T16:20:20+00:00",
        "end": "2024-04-10T16:50:24+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "275978004",
          "display": "Screening for malignant neoplasm of colon (procedure)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0050-18ac59a47a57",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-0050-18ac59a47a57",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73761001",
          "display": "Colonoscopy (procedure)"
        } ],
        "text": "Colonoscopy (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8727-269947ebc32c"
      },
      "performedPeriod": {
        "start": "2024-04-10T16:20:20+00:00",
        "end": "2024-04-10T16:50:24+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4180-9ad644d5f3d9",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-4180-9ad644d5f3d9",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2024-04-10T16:20:20+00:00",
        "end": "2024-04-10T16:50:24+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0050-18ac59a47a57"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-8727-269947ebc32c"
        } ]
      }, {
        "sequence": 2,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "73761001"
          } ]
        },
        "net": {
          "value": 13608.61,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 13694.16,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:791f7831-d356-95ba-c172-193c0fb5dc2a",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "791f7831-d356-95ba-c172-193c0fb5dc2a",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicare"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-4180-9ad644d5f3d9"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2024-04-10T16:50:24+00:00",
        "end": "2025-04-10T16:50:24+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "73761001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 2721.722,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 10886.888,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 13608.61,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 13608.61,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 13694.16,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 10955.328000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-8f28-ca5748b44e51",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2024-06-29T14:42:27+00:00",
        "end": "2024-06-29T15:38:02+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f3f6-cfe839d2c6ed",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-f3f6-cfe839d2c6ed",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "onsetDateTime": "2024-06-29T14:42:27+00:00",
      "abatementDateTime": "2024-06-29T14:42:27+00:00",
      "assertedDate": "2024-06-29T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-fb76-62e3749bac23",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ],
        "text": "Gingivitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "onsetDateTime": "2024-06-29T17:19:15+00:00",
      "abatementDateTime": "2024-07-13T20:05:40+00:00",
      "assertedDate": "2024-06-29T17:19:15+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e01d-2ea3b674c089",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e01d-2ea3b674c089",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 5.8300,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0148-b383ed4001f8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-0148-b383ed4001f8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f105-9a035964249f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f105-9a035964249f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d0ba-a1874446c181",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d0ba-a1874446c181",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4f71-19da4923e2ab",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4f71-19da4923e2ab",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1e0b-543fad745009",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1e0b-543fad745009",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 73,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 101,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-34b7-92871e646939",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-34b7-92871e646939",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 86,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dee5-ebd86023799c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-dee5-ebd86023799c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2ec7-96bd8357f56f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2ec7-96bd8357f56f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.920,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f119-fe7f778ebd24",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f119-fe7f778ebd24",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 18.060,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ab57-89796e77392e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ab57-89796e77392e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0.85000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4734-067afecc2efa",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4734-067afecc2efa",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.9000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0df7-20d3f040db97",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-0df7-20d3f040db97",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 137.84,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-370a-534c78473aa3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-370a-534c78473aa3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 3.7000,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b97b-7fa1ce04a47a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b97b-7fa1ce04a47a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 109.92,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b523-df4a19106cc8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b523-df4a19106cc8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 23.830,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fae7-ddd874cfb760",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-fae7-ddd874cfb760",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2093-3",
          "display": "Cholesterol [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Cholesterol [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 155.84,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-615a-e01dcb1797a3",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-615a-e01dcb1797a3",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2571-8",
          "display": "Triglyceride [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Triglyceride [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 101.18,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d27b-78da4254540e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d27b-78da4254540e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "18262-6",
          "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
        } ],
        "text": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 106.82,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-422b-dbeeb5ce98c7",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-422b-dbeeb5ce98c7",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2085-9",
          "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
        } ],
        "text": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 28.780,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fafe-c1de1dd1a06d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-fafe-c1de1dd1a06d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-137f-dee80d0e34c2",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-137f-dee80d0e34c2",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T15:38:02+00:00",
      "issued": "2024-06-29T15:38:02.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA6568-5",
            "display": "Not at all"
          } ],
          "text": "Not at all"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30131-9",
            "display": "3 to 5 times a week"
          } ],
          "text": "3 to 5 times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA15652-3",
            "display": "Medicare"
          } ],
          "text": "Medicare"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30136-8",
            "display": "Full-time work"
          } ],
          "text": "Full-time work"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4a6b-0fc93c4a4729",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4a6b-0fc93c4a4729",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "70274-6",
          "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T16:06:45+00:00",
      "issued": "2024-06-29T16:06:45.042+00:00",
      "valueQuantity": {
        "value": 3,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c4ba-ccb1df42e4a1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c4ba-ccb1df42e4a1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55758-7",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T16:40:47+00:00",
      "issued": "2024-06-29T16:40:47.042+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3a19-90da9b2a9a3e",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3a19-90da9b2a9a3e",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "75626-2",
          "display": "Total score [AUDIT-C]"
        } ],
        "text": "Total score [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T17:19:15+00:00",
      "issued": "2024-06-29T17:19:15.042+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f69f-b84b4360df46",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-f69f-b84b4360df46",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T14:42:27+00:00",
        "end": "2024-06-29T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2c36-97b37d10d2b7",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-2c36-97b37d10d2b7",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T14:42:27+00:00",
        "end": "2024-06-29T15:38:02+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f504-cd74e4e796f2",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-f504-cd74e4e796f2",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710841007",
          "display": "Assessment of anxiety (procedure)"
        } ],
        "text": "Assessment of anxiety (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T15:38:02+00:00",
        "end": "2024-06-29T16:06:45+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-be59-0795ae0be0e4",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-be59-0795ae0be0e4",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T16:06:45+00:00",
        "end": "2024-06-29T16:17:47+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6928-5d9817297c6a",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-6928-5d9817297c6a",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T16:17:47+00:00",
        "end": "2024-06-29T16:40:47+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-49d3-4e81fa21bfcc",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-49d3-4e81fa21bfcc",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T16:40:47+00:00",
        "end": "2024-06-29T16:53:15+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d1b6-989b20ba8996",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-d1b6-989b20ba8996",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "763302001",
          "display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
        } ],
        "text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T16:53:15+00:00",
        "end": "2024-06-29T17:19:15+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4f70-7f858a68cdb9",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-4f70-7f858a68cdb9",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "103697008",
          "display": "Patient referral for dental care (procedure)"
        } ],
        "text": "Patient referral for dental care (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "performedPeriod": {
        "start": "2024-06-29T17:19:15+00:00",
        "end": "2024-06-29T17:38:20+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6659-8c9841ee7598",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-6659-8c9841ee7598",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "authoredOn": "2024-06-29T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e47e-ca126869e375",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-e47e-ca126869e375",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2024-06-29T14:42:27+00:00",
        "end": "2024-06-29T15:38:02+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-6659-8c9841ee7598"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dde5-56c58e1fdc80",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-dde5-56c58e1fdc80",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "authoredOn": "2024-06-29T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a9e6-d537a2434afd",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-a9e6-d537a2434afd",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2024-06-29T14:42:27+00:00",
        "end": "2024-06-29T15:38:02+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-dde5-56c58e1fdc80"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b2ca-2170c1065fa7",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-b2ca-2170c1065fa7",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "date": "2024-06-29T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3dc4-9c4a5d142e82",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-3dc4-9c4a5d142e82",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "133",
          "display": "Pneumococcal conjugate PCV 13"
        } ],
        "text": "Pneumococcal conjugate PCV 13"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "date": "2024-06-29T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7794-437cd97072d8",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-7794-437cd97072d8",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-2ec7-96bd8357f56f",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f119-fe7f778ebd24",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-ab57-89796e77392e",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-4734-067afecc2efa",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-0df7-20d3f040db97",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-370a-534c78473aa3",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b97b-7fa1ce04a47a",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b523-df4a19106cc8",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-65b9-71643355e8c7",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-65b9-71643355e8c7",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "57698-3",
          "display": "Lipid panel with direct LDL - Serum or Plasma"
        } ],
        "text": "Lipid panel with direct LDL - Serum or Plasma"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T14:42:27+00:00",
      "issued": "2024-06-29T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-fae7-ddd874cfb760",
        "display": "Cholesterol [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-615a-e01dcb1797a3",
        "display": "Triglyceride [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-d27b-78da4254540e",
        "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-422b-dbeeb5ce98c7",
        "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f50a-45a441538573",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-f50a-45a441538573",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69737-5",
          "display": "Generalized anxiety disorder 7 item (GAD-7)"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T16:06:45+00:00",
      "issued": "2024-06-29T16:06:45.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-4a6b-0fc93c4a4729",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f326-fcb7f27506ef",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-f326-fcb7f27506ef",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55757-9",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T16:40:47+00:00",
      "issued": "2024-06-29T16:40:47.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-c4ba-ccb1df42e4a1",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c87a-88893ec8b182",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-c87a-88893ec8b182",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72109-2",
          "display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
        } ],
        "text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
      },
      "effectiveDateTime": "2024-06-29T17:19:15+00:00",
      "issued": "2024-06-29T17:19:15.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-3a19-90da9b2a9a3e",
        "display": "Total score [AUDIT-C]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-16dc-bc65d3a3e5b5",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-16dc-bc65d3a3e5b5",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2024-06-29T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b127-de1c53bf229b",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-b127-de1c53bf229b",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2024-06-29T14:42:27+00:00",
        "end": "2024-06-29T15:38:02+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-b2ca-2170c1065fa7"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3dc4-9c4a5d142e82"
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 7,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 8,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f3f6-cfe839d2c6ed"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f69f-b84b4360df46"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-2c36-97b37d10d2b7"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f504-cd74e4e796f2"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-be59-0795ae0be0e4"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6928-5d9817297c6a"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-49d3-4e81fa21bfcc"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-d1b6-989b20ba8996"
        }
      }, {
        "sequence": 8,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-4f70-7f858a68cdb9"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-8f28-ca5748b44e51"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 5,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 236.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "informationLinkId": [ 7 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "procedureLinkId": [ 6 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 16,
        "procedureLinkId": [ 7 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 17,
        "informationLinkId": [ 8 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 18,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 19,
        "procedureLinkId": [ 8 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "103697008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 4044.70,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e739518a-a734-d74d-00fa-72d6c700eb62",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "e739518a-a734-d74d-00fa-72d6c700eb62",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicare"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-b127-de1c53bf229b"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2024-06-29T15:38:02+00:00",
        "end": "2025-06-29T15:38:02+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f3f6-cfe839d2c6ed"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 47.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 189.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 236.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 236.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 16,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 17,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 18,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 19,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "103697008"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1232.56,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 3235.76,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-f60c-7ff192203697",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "185349003",
          "display": "Encounter for check up (procedure)"
        } ],
        "text": "Encounter for check up (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        }
      } ],
      "period": {
        "start": "2024-07-13T14:42:27+00:00",
        "end": "2024-07-13T21:30:01+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-39ec-eab7e39ba61f",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-39ec-eab7e39ba61f",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "18718003",
          "display": "Gingival disease (disorder)"
        } ],
        "text": "Gingival disease (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "onsetDateTime": "2024-07-13T17:19:12+00:00",
      "abatementDateTime": "2024-07-13T19:03:01+00:00",
      "assertedDate": "2024-07-13T17:19:12+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6821-074b36604bf2",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-6821-074b36604bf2",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "109570002",
          "display": "Primary dental caries (disorder)"
        } ],
        "text": "Primary dental caries (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "onsetDateTime": "2024-07-13T20:05:40+00:00",
      "abatementDateTime": "2024-07-13T20:48:36+00:00",
      "assertedDate": "2024-07-13T20:05:40+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bb3a-ca6dfa12fe79",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-bb3a-ca6dfa12fe79",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "34043003",
          "display": "Dental consultation and report (procedure)"
        } ],
        "text": "Dental consultation and report (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T14:42:27+00:00",
        "end": "2024-07-13T15:22:02+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-55c6-a2e46e4ede7f",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-55c6-a2e46e4ede7f",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "225362009",
          "display": "Dental care (regime/therapy)"
        } ],
        "text": "Dental care (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T15:22:02+00:00",
        "end": "2024-07-13T15:56:27+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2f51-407951cdbe56",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-2f51-407951cdbe56",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1260009003",
          "display": "Removal of supragingival plaque and calculus from all teeth using dental instrument (procedure)"
        } ],
        "text": "Removal of supragingival plaque and calculus from all teeth using dental instrument (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T15:56:27+00:00",
        "end": "2024-07-13T16:30:29+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e474-a98f3d8c71be",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-e474-a98f3d8c71be",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1260010008",
          "display": "Removal of subgingival plaque and calculus from all teeth using dental instrument (procedure)"
        } ],
        "text": "Removal of subgingival plaque and calculus from all teeth using dental instrument (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T16:30:29+00:00",
        "end": "2024-07-13T16:48:27+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c297-dfd011cc9bef",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-c297-dfd011cc9bef",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "274788003",
          "display": "Examination of gingivae (procedure)"
        } ],
        "text": "Examination of gingivae (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T16:48:27+00:00",
        "end": "2024-07-13T17:19:12+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-504c-f56e88e01171",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-504c-f56e88e01171",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "81733005",
          "display": "Dental surgical procedure (procedure)"
        } ],
        "text": "Dental surgical procedure (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T17:19:12+00:00",
        "end": "2024-07-13T17:24:32+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-39ec-eab7e39ba61f",
        "display": "Gingival disease (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-31bc-cbbc931695f6",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-31bc-cbbc931695f6",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "3802001",
          "display": "Dental application of desensitizing medicament (procedure)"
        } ],
        "text": "Dental application of desensitizing medicament (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T17:24:32+00:00",
        "end": "2024-07-13T18:07:31+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-39ec-eab7e39ba61f",
        "display": "Gingival disease (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3d63-49a4e5bd4169",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-3d63-49a4e5bd4169",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "64544008",
          "display": "Gingivectomy or gingivoplasty, per tooth (procedure)"
        } ],
        "text": "Gingivectomy or gingivoplasty, per tooth (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T18:07:31+00:00",
        "end": "2024-07-13T19:03:01+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-39ec-eab7e39ba61f",
        "display": "Gingival disease (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ca75-faed4f9a18e7",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-ca75-faed4f9a18e7",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "456191000124101",
          "display": "Postoperative care for dental procedure (regime/therapy)"
        } ],
        "text": "Postoperative care for dental procedure (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T19:03:01+00:00",
        "end": "2024-07-13T20:05:40+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6ed6-c47372dae62f",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-6ed6-c47372dae62f",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1259293006",
          "display": "Application of composite dental filling material to dentin of tooth following fracture of tooth (procedure)"
        } ],
        "text": "Application of composite dental filling material to dentin of tooth following fracture of tooth (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T20:05:40+00:00",
        "end": "2024-07-13T20:48:36+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-bfb6-03414bbb28cb",
        "display": "Primary dental caries (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-6821-074b36604bf2",
        "display": "Primary dental caries (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2268-29399a5a6230",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-2268-29399a5a6230",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "68071007",
          "display": "Dental fluoride treatment (procedure)"
        } ],
        "text": "Dental fluoride treatment (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T20:48:36+00:00",
        "end": "2024-07-13T21:18:52+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3059-b3c87ad645e4",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-3059-b3c87ad645e4",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "243085009",
          "display": "Oral health education (procedure)"
        } ],
        "text": "Oral health education (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "performedPeriod": {
        "start": "2024-07-13T21:18:52+00:00",
        "end": "2024-07-13T21:30:01+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9c9a-d5829a6ad369",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-9c9a-d5829a6ad369",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "1535362",
          "display": "sodium fluoride 0.0272 MG/MG Oral Gel"
        } ],
        "text": "sodium fluoride 0.0272 MG/MG Oral Gel"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "authoredOn": "2024-07-13T20:48:36+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999988196",
          "display": "Dr. Nathanael908 Rogahn59"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
          "display": "T MASSACHUSETTS, LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c0b2-825bf4fb470f",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-c0b2-825bf4fb470f",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2024-07-13T14:42:27+00:00",
        "end": "2024-07-13T21:30:01+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9c9a-d5829a6ad369"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
        } ]
      } ],
      "total": {
        "value": 129.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:4efcd469-8781-f8a1-a0f1-3b6e0cb39d72",
    "resource": {
      "resourceType": "MedicationAdministration",
      "id": "4efcd469-8781-f8a1-a0f1-3b6e0cb39d72",
      "status": "completed",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "1535362",
          "display": "sodium fluoride 0.0272 MG/MG Oral Gel"
        } ],
        "text": "sodium fluoride 0.0272 MG/MG Oral Gel"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
      },
      "effectiveDateTime": "2024-07-13T20:48:36+00:00",
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5ed4-66c960d03b3c"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb76-62e3749bac23"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationAdministration"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cd2d-586d3c0fa44f",
    "resource": {
      "resourceType": "Device",
      "id": "e63ee044-44a6-784d-cd2d-586d3c0fa44f",
      "udi": {
        "deviceIdentifier": "76949053361709",
        "carrierHRF": "(01)76949053361709(11)240622(17)490707(10)55623046305889(21)3970010"
      },
      "status": "active",
      "type": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "225738002",
          "display": "Operating room (environment)"
        } ],
        "text": "Operating room (environment)"
      },
      "lotNumber": "55623046305889",
      "manufactureDate": "2024-06-22T17:19:12+00:00",
      "expirationDate": "2049-07-07T17:19:12+00:00",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      }
    },
    "request": {
      "method": "POST",
      "url": "Device"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-bd7a-01980ab7fc9e",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-bd7a-01980ab7fc9e",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 1
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "277183007",
            "display": "Dental equipment (physical object)"
          } ],
          "text": "Dental equipment (physical object)"
        }
      },
      "occurrenceDateTime": "2024-07-13T15:56:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b008-a21af2a2c346",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-b008-a21af2a2c346",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 1
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "1230220004",
            "display": "Conventional release periodontal gel (dose form)"
          } ],
          "text": "Conventional release periodontal gel (dose form)"
        }
      },
      "occurrenceDateTime": "2024-07-13T15:56:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a090-396eb1af05ef",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-a090-396eb1af05ef",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 1
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "469020004",
            "display": "Dental floss (physical object)"
          } ],
          "text": "Dental floss (physical object)"
        }
      },
      "occurrenceDateTime": "2024-07-13T15:56:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-36bc-9cca6d30461e",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-36bc-9cca6d30461e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2024-07-13T14:42:27+00:00",
        "end": "2024-07-13T21:30:01+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c0a33465-d309-3d2a-932e-9d554a7cc19c",
        "display": "T MASSACHUSETTS, LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-39ec-eab7e39ba61f"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6821-074b36604bf2"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-bb3a-ca6dfa12fe79"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-55c6-a2e46e4ede7f"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-2f51-407951cdbe56"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-e474-a98f3d8c71be"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-c297-dfd011cc9bef"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-504c-f56e88e01171"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-31bc-cbbc931695f6"
        }
      }, {
        "sequence": 8,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3d63-49a4e5bd4169"
        }
      }, {
        "sequence": 9,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ca75-faed4f9a18e7"
        }
      }, {
        "sequence": 10,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6ed6-c47372dae62f"
        }
      }, {
        "sequence": 11,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-2268-29399a5a6230"
        }
      }, {
        "sequence": 12,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3059-b3c87ad645e4"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f60c-7ff192203697"
        } ]
      }, {
        "sequence": 2,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "34043003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "225362009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260009003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260010008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "274788003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 11,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 0.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 6 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "81733005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "procedureLinkId": [ 7 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "3802001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "procedureLinkId": [ 8 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "64544008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "procedureLinkId": [ 9 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "456191000124101"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 16,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 17,
        "procedureLinkId": [ 10 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1259293006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 18,
        "procedureLinkId": [ 11 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "68071007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 19,
        "procedureLinkId": [ 12 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "243085009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 5262.35,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:3e304773-a1c8-b662-e6fe-507e0507df42",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "3e304773-a1c8-b662-e6fe-507e0507df42",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicare"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-36bc-9cca6d30461e"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2024-07-13T21:30:01+00:00",
        "end": "2025-07-13T21:30:01+00:00"
      },
      "provider": {
        "identifier": {
          "value": "ffa941f5-20d6-388c-bba8-4870a2abafb4"
        }
      },
      "organization": {
        "identifier": {
          "value": "c0a33465-d309-3d2a-932e-9d554a7cc19c"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999988196"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-39ec-eab7e39ba61f"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-6821-074b36604bf2"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 17.11,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 68.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 85.55,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "34043003"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "225362009"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260009003"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1260010008"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "274788003"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 0.0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 0.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "81733005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "3802001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "64544008"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "456191000124101"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 16,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 17,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "1259293006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 18,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "68071007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 19,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "243085009"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 5262.35,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 4209.879999999999,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-63bc-fab3be8e5d3a",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2025-07-05T14:42:27+00:00",
        "end": "2025-07-05T15:21:25+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5027-f402e452c122",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-5027-f402e452c122",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "onsetDateTime": "2025-07-05T14:42:27+00:00",
      "abatementDateTime": "2025-07-05T14:42:27+00:00",
      "assertedDate": "2025-07-05T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e39c-01f9676463d2",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-e39c-01f9676463d2",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73438004",
          "display": "Unemployed (finding)"
        } ],
        "text": "Unemployed (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "onsetDateTime": "2025-07-05T15:21:25+00:00",
      "abatementDateTime": "2026-07-11T15:12:47+00:00",
      "assertedDate": "2025-07-05T15:21:25+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8ac2-182057f30fd5",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-8ac2-182057f30fd5",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.2100,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b540-2d71b8d9e083",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b540-2d71b8d9e083",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-813c-ae379bc88d07",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-813c-ae379bc88d07",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1fed-4bb2fbaeecd0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1fed-4bb2fbaeecd0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4194-bd1778cdb180",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4194-bd1778cdb180",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-eb53-68760a2ae675",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-eb53-68760a2ae675",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 68,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 101,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5018-91ddc6577d93",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-5018-91ddc6577d93",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 76,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4a5e-aef5dbb18348",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4a5e-aef5dbb18348",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ce79-53b154e67ed8",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ce79-53b154e67ed8",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 69.860,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9f69-ba8452899291",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9f69-ba8452899291",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 14.990,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2d21-30853150d749",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2d21-30853150d749",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0.90000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-13c2-64a2fbb43724",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-13c2-64a2fbb43724",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.5800,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9d4f-0211717d1f5d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9d4f-0211717d1f5d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 143.11,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9790-88c6a8e4182a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9790-88c6a8e4182a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 3.8500,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-cc99-c800b63f0a2a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-cc99-c800b63f0a2a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 103.17,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0b17-521e132e0b07",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-0b17-521e132e0b07",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 22.020,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e1ef-b404861694be",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e1ef-b404861694be",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ed14-28f85d4b23eb",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ed14-28f85d4b23eb",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T15:21:25+00:00",
      "issued": "2025-07-05T15:21:25.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA6568-5",
            "display": "Not at all"
          } ],
          "text": "Not at all"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30132-7",
            "display": "5 or more times a week"
          } ],
          "text": "5 or more times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30125-1",
            "display": "Food"
          } ],
          "text": "Food"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA15652-3",
            "display": "Medicare"
          } ],
          "text": "Medicare"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA17956-6",
            "display": "Unemployed"
          } ],
          "text": "Unemployed"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f5ff-7608d3629485",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f5ff-7608d3629485",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "70274-6",
          "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T15:49:45+00:00",
      "issued": "2025-07-05T15:49:45.042+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4de2-4c8a252d8a73",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-4de2-4c8a252d8a73",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "59460-6",
          "display": "Fall risk total [Morse Fall Scale]"
        } ],
        "text": "Fall risk total [Morse Fall Scale]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T16:14:43+00:00",
      "issued": "2025-07-05T16:14:43.042+00:00",
      "valueQuantity": {
        "value": 30,
        "unit": "{#}",
        "system": "http://unitsofmeasure.org",
        "code": "{#}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9f41-0604e05c9243",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-9f41-0604e05c9243",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "59461-4",
          "display": "Fall risk level [Morse Fall Scale]"
        } ],
        "text": "Fall risk level [Morse Fall Scale]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T16:14:43+00:00",
      "issued": "2025-07-05T16:14:43.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "LA13039-5",
          "display": "Moderate Risk (MFS Score 25 - 45)"
        } ],
        "text": "Moderate Risk (MFS Score 25 - 45)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d3e5-712948fe7f60",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d3e5-712948fe7f60",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "76504-0",
          "display": "Total score [HARK]"
        } ],
        "text": "Total score [HARK]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T16:45:08+00:00",
      "issued": "2025-07-05T16:45:08.042+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3204-4c3f78c99142",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-3204-4c3f78c99142",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55758-7",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T17:21:40+00:00",
      "issued": "2025-07-05T17:21:40.042+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-33e8-4bb931a714c1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-33e8-4bb931a714c1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "75626-2",
          "display": "Total score [AUDIT-C]"
        } ],
        "text": "Total score [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T17:58:16+00:00",
      "issued": "2025-07-05T17:58:16.042+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0f83-fb8670510aef",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-0f83-fb8670510aef",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T14:42:27+00:00",
        "end": "2025-07-05T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9fbf-34de7d82bc43",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-9fbf-34de7d82bc43",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T14:42:27+00:00",
        "end": "2025-07-05T15:21:25+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ab46-f83de4c2761e",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-ab46-f83de4c2761e",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710841007",
          "display": "Assessment of anxiety (procedure)"
        } ],
        "text": "Assessment of anxiety (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T15:21:25+00:00",
        "end": "2025-07-05T15:49:45+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1006-f41902697360",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-1006-f41902697360",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "762993000",
          "display": "Assessment using Morse Fall Scale (procedure)"
        } ],
        "text": "Assessment using Morse Fall Scale (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T15:49:45+00:00",
        "end": "2025-07-05T16:14:43+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-09b0-6e2436bc4b44",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-09b0-6e2436bc4b44",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "866148006",
          "display": "Screening for domestic abuse (procedure)"
        } ],
        "text": "Screening for domestic abuse (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T16:14:43+00:00",
        "end": "2025-07-05T16:45:08+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e6cf-6e76144e6442",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-e6cf-6e76144e6442",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T16:45:08+00:00",
        "end": "2025-07-05T16:58:48+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-dd24-fd54b59670b2",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-dd24-fd54b59670b2",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T16:58:48+00:00",
        "end": "2025-07-05T17:21:40+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-eef3-fe0792cb2c40",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-eef3-fe0792cb2c40",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T17:21:40+00:00",
        "end": "2025-07-05T17:31:48+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3b5a-9550e0c29048",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-3b5a-9550e0c29048",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "763302001",
          "display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
        } ],
        "text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "performedPeriod": {
        "start": "2025-07-05T17:31:48+00:00",
        "end": "2025-07-05T17:58:16+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-719a-4969f9347b44",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-719a-4969f9347b44",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "authoredOn": "2025-07-05T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1f42-5513c1be6e59",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-1f42-5513c1be6e59",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2025-07-05T14:42:27+00:00",
        "end": "2025-07-05T15:21:25+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-719a-4969f9347b44"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f4e5-0da0ad295413",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-f4e5-0da0ad295413",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "authoredOn": "2025-07-05T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-08b2-5833085ea3ed",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-08b2-5833085ea3ed",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2025-07-05T14:42:27+00:00",
        "end": "2025-07-05T15:21:25+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f4e5-0da0ad295413"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
        } ]
      } ],
      "total": {
        "value": 0.96,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-86f0-bd09d5d56003",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-86f0-bd09d5d56003",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "date": "2025-07-05T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3e8b-2737503ca4b3",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-3e8b-2737503ca4b3",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "33",
          "display": "pneumococcal polysaccharide vaccine, 23 valent"
        } ],
        "text": "pneumococcal polysaccharide vaccine, 23 valent"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "date": "2025-07-05T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-8421-8650a855872b",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-8421-8650a855872b",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T14:42:27+00:00",
      "issued": "2025-07-05T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-ce79-53b154e67ed8",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9f69-ba8452899291",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-2d21-30853150d749",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-13c2-64a2fbb43724",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9d4f-0211717d1f5d",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9790-88c6a8e4182a",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-cc99-c800b63f0a2a",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-0b17-521e132e0b07",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5e4f-fb73a9545f71",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-5e4f-fb73a9545f71",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69737-5",
          "display": "Generalized anxiety disorder 7 item (GAD-7)"
        } ],
        "text": "Generalized anxiety disorder 7 item (GAD-7)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T15:49:45+00:00",
      "issued": "2025-07-05T15:49:45.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-f5ff-7608d3629485",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3782-8692ad142b88",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-3782-8692ad142b88",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "59453-1",
          "display": "Morse Fall Scale panel"
        } ],
        "text": "Morse Fall Scale panel"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T16:14:43+00:00",
      "issued": "2025-07-05T16:14:43.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-4de2-4c8a252d8a73",
        "display": "Fall risk total [Morse Fall Scale]"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-9f41-0604e05c9243",
        "display": "Fall risk level [Morse Fall Scale]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7230-e193266498a7",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-7230-e193266498a7",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "76499-3",
          "display": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
        } ],
        "text": "Humiliation, Afraid, Rape, and Kick questionnaire [HARK]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T16:45:08+00:00",
      "issued": "2025-07-05T16:45:08.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-d3e5-712948fe7f60",
        "display": "Total score [HARK]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-04ca-4e161700a5f6",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-04ca-4e161700a5f6",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "55757-9",
          "display": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
        } ],
        "text": "Patient Health Questionnaire 2 item (PHQ-2) [Reported]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T17:21:40+00:00",
      "issued": "2025-07-05T17:21:40.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-3204-4c3f78c99142",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b65c-5585add893a2",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-b65c-5585add893a2",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72109-2",
          "display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
        } ],
        "text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
      },
      "effectiveDateTime": "2025-07-05T17:58:16+00:00",
      "issued": "2025-07-05T17:58:16.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-33e8-4bb931a714c1",
        "display": "Total score [AUDIT-C]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4b5b-c1a2f47a26fc",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-4b5b-c1a2f47a26fc",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2025-07-05T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5b15-6818be383bba",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-5b15-6818be383bba",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2025-07-05T14:42:27+00:00",
        "end": "2025-07-05T15:21:25+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-86f0-bd09d5d56003"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3e8b-2737503ca4b3"
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 7,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 8,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 9,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5027-f402e452c122"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-e39c-01f9676463d2"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-0f83-fb8670510aef"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-9fbf-34de7d82bc43"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-ab46-f83de4c2761e"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-1006-f41902697360"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-09b0-6e2436bc4b44"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-e6cf-6e76144e6442"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-dd24-fd54b59670b2"
        }
      }, {
        "sequence": 8,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-eef3-fe0792cb2c40"
        }
      }, {
        "sequence": 9,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-3b5a-9550e0c29048"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-63bc-fab3be8e5d3a"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 5,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 215.70,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 10,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "762993000"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "866148006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "informationLinkId": [ 7 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 16,
        "procedureLinkId": [ 6 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 17,
        "procedureLinkId": [ 7 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 18,
        "informationLinkId": [ 8 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 19,
        "procedureLinkId": [ 8 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 20,
        "procedureLinkId": [ 9 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 21,
        "informationLinkId": [ 9 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 4529.98,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7e128310-e343-d0c5-e449-04627f55e5fe",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "7e128310-e343-d0c5-e449-04627f55e5fe",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicare"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-5b15-6818be383bba"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2025-07-05T15:21:25+00:00",
        "end": "2026-07-05T15:21:25+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5027-f402e452c122"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-e39c-01f9676463d2"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 43.14,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 172.56,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 215.70,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 215.70,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710841007"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "762993000"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "866148006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 16,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 17,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 18,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 19,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 20,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 21,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1137.28,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 3623.9840000000004,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11",
    "resource": {
      "resourceType": "Encounter",
      "id": "e63ee044-44a6-784d-f98c-0f3e8d6abf11",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "162673000",
          "display": "General examination of patient (procedure)"
        } ],
        "text": "General examination of patient (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        }
      } ],
      "period": {
        "start": "2026-07-11T14:42:27+00:00",
        "end": "2026-07-11T15:12:47+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e16f-1b3e8bb218ae",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-e16f-1b3e8bb218ae",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "314529007",
          "display": "Medication review due (situation)"
        } ],
        "text": "Medication review due (situation)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "onsetDateTime": "2026-07-11T14:42:27+00:00",
      "abatementDateTime": "2026-07-11T14:42:27+00:00",
      "assertedDate": "2026-07-11T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f3ee-25c8804570b5",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-f3ee-25c8804570b5",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "741062008",
          "display": "Not in labor force (finding)"
        } ],
        "text": "Not in labor force (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "onsetDateTime": "2026-07-11T15:12:47+00:00",
      "assertedDate": "2026-07-11T15:12:47+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-399d-f2012491baec",
    "resource": {
      "resourceType": "Condition",
      "id": "e63ee044-44a6-784d-399d-f2012491baec",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73595000",
          "display": "Stress (finding)"
        } ],
        "text": "Stress (finding)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "onsetDateTime": "2026-07-11T15:12:47+00:00",
      "assertedDate": "2026-07-11T15:12:47+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-ffc9-31a46a69406f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-ffc9-31a46a69406f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4548-4",
          "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
        } ],
        "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 6.1400,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-2cc6-70adc3680214",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-2cc6-70adc3680214",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8302-2",
          "display": "Body Height"
        } ],
        "text": "Body Height"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 171.30,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-74f2-8ea675a55fbe",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-74f2-8ea675a55fbe",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72514-3",
          "display": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
        } ],
        "text": "Pain severity - 0-10 verbal numeric rating [Score] - Reported"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 3,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f751-434aebf1ed75",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f751-434aebf1ed75",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "29463-7",
          "display": "Body Weight"
        } ],
        "text": "Body Weight"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 81.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b96b-9cb540fd7bd7",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b96b-9cb540fd7bd7",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "39156-5",
          "display": "Body mass index (BMI) [Ratio]"
        } ],
        "text": "Body mass index (BMI) [Ratio]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 27.740,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a984-901d31d80c70",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a984-901d31d80c70",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "85354-9",
          "display": "Blood pressure panel with all children optional"
        } ],
        "text": "Blood pressure panel with all children optional"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 74,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8480-6",
            "display": "Systolic Blood Pressure"
          } ],
          "text": "Systolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 111,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c3b2-fecccd6b4b5d",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c3b2-fecccd6b4b5d",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "8867-4",
          "display": "Heart rate"
        } ],
        "text": "Heart rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 86,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-0870-5416cd13dc60",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-0870-5416cd13dc60",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "vital-signs",
          "display": "vital-signs"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "9279-1",
          "display": "Respiratory rate"
        } ],
        "text": "Respiratory rate"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7d2b-6ee3278f635a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7d2b-6ee3278f635a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2339-0",
          "display": "Glucose [Mass/volume] in Blood"
        } ],
        "text": "Glucose [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 87.160,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-7651-69bf9a3ec69c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-7651-69bf9a3ec69c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6299-2",
          "display": "Urea nitrogen [Mass/volume] in Blood"
        } ],
        "text": "Urea nitrogen [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.8100,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-f980-252f1ef34a8a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-f980-252f1ef34a8a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "38483-4",
          "display": "Creatinine [Mass/volume] in Blood"
        } ],
        "text": "Creatinine [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 0.97000,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-abbf-b7084a211a5b",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-abbf-b7084a211a5b",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "49765-1",
          "display": "Calcium [Mass/volume] in Blood"
        } ],
        "text": "Calcium [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 8.6600,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e2e6-f42bdcbccb55",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e2e6-f42bdcbccb55",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2947-0",
          "display": "Sodium [Moles/volume] in Blood"
        } ],
        "text": "Sodium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 142.59,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a514-ef7507e27f4c",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a514-ef7507e27f4c",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6298-4",
          "display": "Potassium [Moles/volume] in Blood"
        } ],
        "text": "Potassium [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 3.8400,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-29b7-46fdba480c70",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-29b7-46fdba480c70",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "2069-3",
          "display": "Chloride [Moles/volume] in Blood"
        } ],
        "text": "Chloride [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 110.35,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-95c0-e13f010953ac",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-95c0-e13f010953ac",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "20565-8",
          "display": "Carbon dioxide, total [Moles/volume] in Blood"
        } ],
        "text": "Carbon dioxide, total [Moles/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 21,
        "unit": "mmol/L",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5bac-a7032e874d05",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-5bac-a7032e874d05",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "6690-2",
          "display": "Leukocytes [#/volume] in Blood by Automated count"
        } ],
        "text": "Leukocytes [#/volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 9.2317,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-de91-de3ec514af87",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-de91-de3ec514af87",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "789-8",
          "display": "Erythrocytes [#/volume] in Blood by Automated count"
        } ],
        "text": "Erythrocytes [#/volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 5.2261,
        "unit": "10*6/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*6/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c983-ccea1f23f552",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-c983-ccea1f23f552",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "718-7",
          "display": "Hemoglobin [Mass/volume] in Blood"
        } ],
        "text": "Hemoglobin [Mass/volume] in Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 17.465,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-d751-d881c3b3d972",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-d751-d881c3b3d972",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "4544-3",
          "display": "Hematocrit [Volume Fraction] of Blood by Automated count"
        } ],
        "text": "Hematocrit [Volume Fraction] of Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 43.081,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-86d5-bdc2a56f29f6",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-86d5-bdc2a56f29f6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "787-2",
          "display": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
        } ],
        "text": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 86.586,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e06c-1e4c51726ec1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e06c-1e4c51726ec1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "785-6",
          "display": "MCH [Entitic mass] by Automated count"
        } ],
        "text": "MCH [Entitic mass] by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 32.801,
        "unit": "pg",
        "system": "http://unitsofmeasure.org",
        "code": "pg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-e3b5-c4809bc4a9a1",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-e3b5-c4809bc4a9a1",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "786-4",
          "display": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
        } ],
        "text": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 35.464,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-30ce-c1b3321383a0",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-30ce-c1b3321383a0",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "788-0",
          "display": "Erythrocyte [DistWidth] in Blood by Automated count"
        } ],
        "text": "Erythrocyte [DistWidth] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 42.276,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a356-ca7e05747b9a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-a356-ca7e05747b9a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "777-3",
          "display": "Platelets [#/volume] in Blood by Automated count"
        } ],
        "text": "Platelets [#/volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 242.80,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1578-7571cdf1ea0f",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1578-7571cdf1ea0f",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "32207-3",
          "display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
        } ],
        "text": "Platelet distribution width [Entitic volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 13.480,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-03d3-3ff54fc3ee3a",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-03d3-3ff54fc3ee3a",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "laboratory",
          "display": "laboratory"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "32623-1",
          "display": "Platelet [Entitic mean volume] in Blood by Automated count"
        } ],
        "text": "Platelet [Entitic mean volume] in Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueQuantity": {
        "value": 10.339,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1b06-7d671f829862",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-1b06-7d671f829862",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "social-history",
          "display": "social-history"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        } ],
        "text": "Tobacco smoking status"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266919005",
          "display": "Never smoked tobacco (finding)"
        } ],
        "text": "Never smoked tobacco (finding)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-293e-ac2719d091c6",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-293e-ac2719d091c6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "93025-5",
          "display": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
        } ],
        "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T15:12:47+00:00",
      "issued": "2026-07-11T15:12:47.042+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76501-6",
            "display": "Within the last year, have you been afraid of your partner or ex-partner"
          } ],
          "text": "Within the last year, have you been afraid of your partner or ex-partner"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93026-3",
            "display": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
          } ],
          "text": "Do you feel physically and emotionally safe where you currently live [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93027-1",
            "display": "Are you a refugee"
          } ],
          "text": "Are you a refugee"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93028-9",
            "display": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
          } ],
          "text": "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93038-8",
            "display": "Stress level"
          } ],
          "text": "Stress level"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA13863-8",
            "display": "A little bit"
          } ],
          "text": "A little bit"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93029-7",
            "display": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
          } ],
          "text": "How often do you see or talk to people that you care about and feel close to [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30132-7",
            "display": "5 or more times a week"
          } ],
          "text": "5 or more times a week"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93030-5",
            "display": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
          } ],
          "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93031-3",
            "display": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
          } ],
          "text": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30122-8",
            "display": "I choose not to answer this question"
          } ],
          "text": "I choose not to answer this question"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63586-2",
            "display": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
          } ],
          "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]"
        },
        "valueQuantity": {
          "value": 91010,
          "unit": "/a",
          "system": "http://unitsofmeasure.org",
          "code": "/a"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "76437-3",
            "display": "Primary insurance"
          } ],
          "text": "Primary insurance"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA15652-3",
            "display": "Medicare"
          } ],
          "text": "Medicare"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "67875-5",
            "display": "Employment status - current"
          } ],
          "text": "Employment status - current"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30137-6",
            "display": "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)"
          } ],
          "text": "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "82589-3",
            "display": "Highest level of education"
          } ],
          "text": "Highest level of education"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30193-9",
            "display": "More than high school"
          } ],
          "text": "More than high school"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "315 Mann Key"
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93033-9",
            "display": "Are you worried about losing your housing [PRAPARE]"
          } ],
          "text": "Are you worried about losing your housing [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "71802-3",
            "display": "Housing status"
          } ],
          "text": "Housing status"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30189-7",
            "display": "I have housing"
          } ],
          "text": "I have housing"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "63512-8",
            "display": "How many people are living or staying at this address [#]"
          } ],
          "text": "How many people are living or staying at this address [#]"
        },
        "valueQuantity": {
          "value": 3,
          "unit": "{#}",
          "system": "http://unitsofmeasure.org",
          "code": "{#}"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "54899-0",
            "display": "Preferred language"
          } ],
          "text": "Preferred language"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA30188-9",
            "display": "Language other than English"
          } ],
          "text": "Language other than English"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93034-7",
            "display": "Discharged from the U.S. Armed Forces"
          } ],
          "text": "Discharged from the U.S. Armed Forces"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "93035-4",
            "display": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
          } ],
          "text": "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "32624-9",
            "display": "Race"
          } ],
          "text": "Race"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA4457-3",
            "display": "White"
          } ],
          "text": "White"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56051-6",
            "display": "Hispanic or Latino"
          } ],
          "text": "Hispanic or Latino"
        },
        "valueCodeableConcept": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-fb85-6e41b31e72ce",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-fb85-6e41b31e72ce",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "59460-6",
          "display": "Fall risk total [Morse Fall Scale]"
        } ],
        "text": "Fall risk total [Morse Fall Scale]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T15:28:36+00:00",
      "issued": "2026-07-11T15:28:36.042+00:00",
      "valueQuantity": {
        "value": 9,
        "unit": "{#}",
        "system": "http://unitsofmeasure.org",
        "code": "{#}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-b420-e5c0c91647bc",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-b420-e5c0c91647bc",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "59461-4",
          "display": "Fall risk level [Morse Fall Scale]"
        } ],
        "text": "Fall risk level [Morse Fall Scale]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T15:28:36+00:00",
      "issued": "2026-07-11T15:28:36.042+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "LA13038-7",
          "display": "Low Risk (MFS Score 0 - 24)"
        } ],
        "text": "Low Risk (MFS Score 0 - 24)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-51b7-3d881c996eef",
    "resource": {
      "resourceType": "Observation",
      "id": "e63ee044-44a6-784d-51b7-3d881c996eef",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "survey",
          "display": "survey"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "75626-2",
          "display": "Total score [AUDIT-C]"
        } ],
        "text": "Total score [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T16:06:33+00:00",
      "issued": "2026-07-11T16:06:33.042+00:00",
      "valueQuantity": {
        "value": 3,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-61c3-46efdf9275a3",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-61c3-46efdf9275a3",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "performedPeriod": {
        "start": "2026-07-11T14:42:27+00:00",
        "end": "2026-07-11T14:57:27+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-503a-1e107b8887b4",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-503a-1e107b8887b4",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "710824005",
          "display": "Assessment of health and social care needs (procedure)"
        } ],
        "text": "Assessment of health and social care needs (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "performedPeriod": {
        "start": "2026-07-11T14:42:27+00:00",
        "end": "2026-07-11T15:12:47+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-12c4-f2b10c90b73d",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-12c4-f2b10c90b73d",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "762993000",
          "display": "Assessment using Morse Fall Scale (procedure)"
        } ],
        "text": "Assessment using Morse Fall Scale (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "performedPeriod": {
        "start": "2026-07-11T15:12:47+00:00",
        "end": "2026-07-11T15:28:36+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-5261-3c626ebe4b45",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-5261-3c626ebe4b45",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "428211000124100",
          "display": "Assessment of substance use (procedure)"
        } ],
        "text": "Assessment of substance use (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "performedPeriod": {
        "start": "2026-07-11T15:28:36+00:00",
        "end": "2026-07-11T15:41:26+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-96f0-97d24536f5fb",
    "resource": {
      "resourceType": "Procedure",
      "id": "e63ee044-44a6-784d-96f0-97d24536f5fb",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "763302001",
          "display": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
        } ],
        "text": "Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "performedPeriod": {
        "start": "2026-07-11T15:41:26+00:00",
        "end": "2026-07-11T16:06:33+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9e47-5ad6f91ffe49",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-9e47-5ad6f91ffe49",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "310798",
          "display": "Hydrochlorothiazide 25 MG Oral Tablet"
        } ],
        "text": "Hydrochlorothiazide 25 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "authoredOn": "2026-07-11T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-6bf1-d55db55a6c14",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-6bf1-d55db55a6c14",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2026-07-11T14:42:27+00:00",
        "end": "2026-07-11T15:12:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e47-5ad6f91ffe49"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
        } ]
      } ],
      "total": {
        "value": 0.45,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-3cbc-d47950ca803a",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "e63ee044-44a6-784d-3cbc-d47950ca803a",
      "status": "active",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "308136",
          "display": "amLODIPine 2.5 MG Oral Tablet"
        } ],
        "text": "amLODIPine 2.5 MG Oral Tablet"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "authoredOn": "2026-07-11T14:42:27+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999949198",
          "display": "Dr. Florance664 Leannon79"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
          "display": "SUNRISE HEALTHCARE LLC"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-9e31-3f1b0d0d308c"
      } ],
      "dosageInstruction": [ {
        "sequence": 1,
        "timing": {
          "repeat": {
            "frequency": 1,
            "period": 1.0,
            "periodUnit": "d"
          }
        },
        "asNeededBoolean": false,
        "doseQuantity": {
          "value": 1.0
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-c184-6aa6084cca03",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-c184-6aa6084cca03",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2026-07-11T14:42:27+00:00",
        "end": "2026-07-11T15:12:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "prescription": {
        "reference": "urn:uuid:e63ee044-44a6-784d-3cbc-d47950ca803a"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
        } ]
      } ],
      "total": {
        "value": 0.91,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-865f-8761bbf8c590",
    "resource": {
      "resourceType": "Immunization",
      "id": "e63ee044-44a6-784d-865f-8761bbf8c590",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "140",
          "display": "Influenza, split virus, trivalent, PF"
        } ],
        "text": "Influenza, split virus, trivalent, PF"
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "encounter": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "date": "2026-07-11T14:42:27+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-227c-5d921a23842a",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-227c-5d921a23842a",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "51990-0",
          "display": "Basic metabolic panel - Blood"
        } ],
        "text": "Basic metabolic panel - Blood"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-7d2b-6ee3278f635a",
        "display": "Glucose [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-7651-69bf9a3ec69c",
        "display": "Urea nitrogen [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-f980-252f1ef34a8a",
        "display": "Creatinine [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-abbf-b7084a211a5b",
        "display": "Calcium [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-e2e6-f42bdcbccb55",
        "display": "Sodium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-a514-ef7507e27f4c",
        "display": "Potassium [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-29b7-46fdba480c70",
        "display": "Chloride [Moles/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-95c0-e13f010953ac",
        "display": "Carbon dioxide, total [Moles/volume] in Blood"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-1c7b-b81c3ec68186",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-1c7b-b81c3ec68186",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "58410-2",
          "display": "CBC panel - Blood by Automated count"
        } ],
        "text": "CBC panel - Blood by Automated count"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T14:42:27+00:00",
      "issued": "2026-07-11T14:42:27.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-5bac-a7032e874d05",
        "display": "Leukocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-de91-de3ec514af87",
        "display": "Erythrocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-c983-ccea1f23f552",
        "display": "Hemoglobin [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-d751-d881c3b3d972",
        "display": "Hematocrit [Volume Fraction] of Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-86d5-bdc2a56f29f6",
        "display": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-e06c-1e4c51726ec1",
        "display": "MCH [Entitic mass] by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-e3b5-c4809bc4a9a1",
        "display": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-30ce-c1b3321383a0",
        "display": "Erythrocyte [DistWidth] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-a356-ca7e05747b9a",
        "display": "Platelets [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-1578-7571cdf1ea0f",
        "display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-03d3-3ff54fc3ee3a",
        "display": "Platelet [Entitic mean volume] in Blood by Automated count"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-a5ec-6747299d58fd",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-a5ec-6747299d58fd",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "59453-1",
          "display": "Morse Fall Scale panel"
        } ],
        "text": "Morse Fall Scale panel"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T15:28:36+00:00",
      "issued": "2026-07-11T15:28:36.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-fb85-6e41b31e72ce",
        "display": "Fall risk total [Morse Fall Scale]"
      }, {
        "reference": "urn:uuid:e63ee044-44a6-784d-b420-e5c0c91647bc",
        "display": "Fall risk level [Morse Fall Scale]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-4cca-49d938bf0a68",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "e63ee044-44a6-784d-4cca-49d938bf0a68",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "72109-2",
          "display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
        } ],
        "text": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
      },
      "subject": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "context": {
        "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
      },
      "effectiveDateTime": "2026-07-11T16:06:33+00:00",
      "issued": "2026-07-11T16:06:33.042+00:00",
      "result": [ {
        "reference": "urn:uuid:e63ee044-44a6-784d-51b7-3d881c996eef",
        "display": "Total score [AUDIT-C]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-9e5b-178e821991ac",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "e63ee044-44a6-784d-9e5b-178e821991ac",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "type": {
        "coding": [ {
          "system": "http://hl7.org/fhir/supply-item-type",
          "code": "device",
          "display": "Device"
        } ]
      },
      "suppliedItem": {
        "quantity": {
          "value": 50
        },
        "itemCodeableConcept": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "code": "337388004",
            "display": "Blood glucose testing strips (physical object)"
          } ],
          "text": "Blood glucose testing strips (physical object)"
        }
      },
      "occurrenceDateTime": "2026-07-11T14:42:27+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:e63ee044-44a6-784d-250c-72236491e9ae",
    "resource": {
      "resourceType": "Claim",
      "id": "e63ee044-44a6-784d-250c-72236491e9ae",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "start": "2026-07-11T14:42:27+00:00",
        "end": "2026-07-11T15:12:47+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2d45ee8-b930-3169-b612-f602961ad212",
        "display": "SUNRISE HEALTHCARE LLC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-865f-8761bbf8c590"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-e16f-1b3e8bb218ae"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f3ee-25c8804570b5"
        }
      }, {
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-399d-f2012491baec"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-61c3-46efdf9275a3"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-503a-1e107b8887b4"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-12c4-f2b10c90b73d"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-5261-3c626ebe4b45"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-96f0-97d24536f5fb"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:e63ee044-44a6-784d-f98c-0f3e8d6abf11"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 4,
        "procedureLinkId": [ 1 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 244.01,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 6.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "procedureLinkId": [ 2 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 10,
        "diagnosisLinkId": [ 3 ]
      }, {
        "sequence": 11,
        "procedureLinkId": [ 3 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "762993000"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 13,
        "procedureLinkId": [ 4 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "procedureLinkId": [ 5 ],
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 15,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 2547.53,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ca6cdcf6-0c44-fa8e-b55d-315d10ca66c2",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "ca6cdcf6-0c44-fa8e-b55d-315d10ca66c2",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicare"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-profnl-cmpnt-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-ptb-coinsrnc-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-prvdr-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-op-bene-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-nch-bene-blood-ddctbl-lblty-am-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-clm-mdcr-non-pmt-rsn-cd-extension",
        "valueCoding": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd",
          "code": "N",
          "display": "All other reasons for non-payment"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-fi-num-extension",
        "valueIdentifier": {
          "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-fi-num",
          "value": "002000"
        }
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "e63ee044-44a6-784d-250c-72236491e9ae"
      }, {
        "system": "https://bluebutton.cms.gov/resources/identifier/claim-group",
        "value": "99999999999"
      } ],
      "status": "active",
      "type": {
        "coding": [ {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_clm_type_cd",
          "code": "71",
          "display": "Local carrier non-durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claim"
        }, {
          "system": "https://bluebutton.cms.gov/resources/codesystem/eob-type",
          "code": "CARRIER",
          "display": "EOB Type"
        }, {
          "system": "http://hl7.org/fhir/ex-claimtype",
          "code": "professional",
          "display": "Claim Type"
        }, {
          "system": "https://bluebutton.cms.gov/resources/variables/nch_near_line_rec_ident_cd",
          "code": "O",
          "display": "Part B physician/supplier claim record (processed by local carriers; can include DMEPOS services)"
        } ]
      },
      "patient": {
        "reference": "urn:uuid:e63ee044-44a6-784d-28a0-0d049d2449a5"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2026-07-11T15:12:47+00:00",
        "end": "2027-07-11T15:12:47+00:00"
      },
      "provider": {
        "identifier": {
          "value": "c0757130-3099-381f-beed-db590a5a50cb"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2d45ee8-b930-3169-b612-f602961ad212"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999949198"
          }
        },
        "role": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          } ]
        }
      } ],
      "diagnosis": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-e16f-1b3e8bb218ae"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-f3ee-25c8804570b5"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-poa-ind-sw1-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1",
            "code": "Y",
            "display": "Diagnosis present at time of admission"
          }
        } ],
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:e63ee044-44a6-784d-399d-f2012491baec"
        },
        "type": [ {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/codesystem/diagnosis-type",
            "code": "principal"
          } ]
        } ]
      } ],
      "insurance": {
        "coverage": {
          "reference": "#coverage"
        }
      },
      "item": [ {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 1,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.360000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 109.44000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 2,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 27.200000000000003,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 108.80000000000001,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 136.00,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 3,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 4,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 48.802,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 195.208,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 244.01,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 244.01,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 5,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 1.36,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 5.44,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 6.80,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 6,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 8,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 9,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 10,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 11,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "762993000"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 12,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 13,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "428211000124100"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 14,
        "service": {
          "extension": [ {
            "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ide-ndc-upc-num-extension",
            "valueCoding": {
              "system": "https://www.accessdata.fda.gov/scripts/cder/ndc",
              "code": "0624",
              "display": "Dummy"
            }
          } ],
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "763302001"
          } ]
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 86.28,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 345.12,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 431.40,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      }, {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-outpatient-rev-cntr-ndc-qty-extension",
          "valueQuantity": {
            "value": 0
          }
        } ],
        "sequence": 15,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        },
        "adjudication": [ {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_coinsrnc_amt",
              "display": "Line Beneficiary Coinsurance Amount"
            } ]
          },
          "amount": {
            "value": 14.916,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prvdr_pmt_amt",
              "display": "Line Provider Payment Amount"
            } ]
          },
          "amount": {
            "value": 59.664,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_sbmtd_chrg_amt",
              "display": "Line Submitted Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt",
              "display": "Line Allowed Charge Amount"
            } ]
          },
          "amount": {
            "value": 74.58,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_bene_ptb_ddctbl_amt",
              "display": "Line Beneficiary Part B Deductible Amount"
            } ]
          },
          "amount": {
            "value": 0,
            "system": "urn:iso:std:iso:4217",
            "code": "USD"
          }
        }, {
          "category": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication",
              "code": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "display": "Line Processing Indicator Code"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1104.17,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2038.0240000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  } ]
}
