{
  "resourceType": "Bundle",
  "type": "transaction",
  "entry": [ {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3",
    "resource": {
      "resourceType": "Patient",
      "id": "7c50e28d-07cc-a4cf-eb58-b2a15bc552a3",
      "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: 8957908754189034703  Population seed: 1784730135182</div>"
      },
      "extension": [ {
        "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
        "extension": [ {
          "url": "ombCategory",
          "valueCoding": {
            "system": "http://hl7.org/fhir/v3/NullFlavor",
            "code": "UNK",
            "display": "Unknown"
          }
        }, {
          "url": "text",
          "valueString": "Other"
        } ]
      }, {
        "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": "2186-5",
            "display": "Not Hispanic or Latino"
          }
        }, {
          "url": "text",
          "valueString": "Not Hispanic or Latino"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
        "valueString": "Giovanna377 Lockman863"
      }, {
        "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
        "valueCode": "F"
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/birthPlace",
        "valueAddress": {
          "city": "Everett",
          "state": "Massachusetts",
          "country": "US"
        }
      }, {
        "url": "http://synthetichealth.github.io/synthea/disability-adjusted-life-years",
        "valueDecimal": 9.777824035458066
      }, {
        "url": "http://synthetichealth.github.io/synthea/quality-adjusted-life-years",
        "valueDecimal": 43.22217596454193
      } ],
      "identifier": [ {
        "system": "https://github.com/synthetichealth/synthea",
        "value": "7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      }, {
        "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": "7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      }, {
        "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": "999-66-7226"
      }, {
        "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": "S99954067"
      }, {
        "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": "X94171630X"
      } ],
      "name": [ {
        "use": "official",
        "family": "Strosin214",
        "given": [ "Margot418", "Otha286" ],
        "prefix": [ "Mrs." ]
      }, {
        "use": "maiden",
        "family": "Parisian75",
        "given": [ "Margot418", "Otha286" ],
        "prefix": [ "Mrs." ]
      } ],
      "telecom": [ {
        "system": "phone",
        "value": "555-359-6222",
        "use": "home"
      } ],
      "gender": "female",
      "birthDate": "1960-03-14",
      "deceasedDateTime": "2014-10-23T09:52:59+00:00",
      "address": [ {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/geolocation",
          "extension": [ {
            "url": "latitude",
            "valueDecimal": 42.629824501376994
          }, {
            "url": "longitude",
            "valueDecimal": -71.3174225938459
          } ]
        } ],
        "line": [ "741 Raynor Gate Suite 86" ],
        "city": "Lowell",
        "state": "Massachusetts",
        "postalCode": "01852",
        "country": "US"
      } ],
      "maritalStatus": {
        "coding": [ {
          "system": "http://hl7.org/fhir/v3/MaritalStatus",
          "code": "D",
          "display": "D"
        } ],
        "text": "D"
      },
      "multipleBirthBoolean": false,
      "communication": [ {
        "language": {
          "coding": [ {
            "system": "urn:ietf:bcp:47",
            "code": "en-US",
            "display": "English (United States)"
          } ],
          "text": "English (United States)"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Patient"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-303a-f48e9cb42633",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-303a-f48e9cb42633",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "1978-05-08T09:32:32+00:00",
        "end": "1978-05-08T10:07:21+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8d60-a1b6cf4b7f8c",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-8d60-a1b6cf4b7f8c",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "224295006",
          "display": "Only received primary school education (finding)"
        } ],
        "text": "Only received primary school education (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-303a-f48e9cb42633"
      },
      "onsetDateTime": "1978-05-08T10:07:21+00:00",
      "assertedDate": "1978-05-08T10:07:21+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4571-a47ea67ed41d",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-4571-a47ea67ed41d",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "713458007",
          "display": "Lack of access to transportation (finding)"
        } ],
        "text": "Lack of access to transportation (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-303a-f48e9cb42633"
      },
      "onsetDateTime": "1978-05-08T10:07:21+00:00",
      "assertedDate": "1978-05-08T10:07:21+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-740f-c8f33d52e13d",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-740f-c8f33d52e13d",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1978-05-08T09:32:32+00:00",
        "end": "1978-05-08T10:07:21+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8d60-a1b6cf4b7f8c"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4571-a47ea67ed41d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-303a-f48e9cb42633"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 2 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:d0653b7a-a31b-237e-3f15-b15e59252727",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "d0653b7a-a31b-237e-3f15-b15e59252727",
      "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": "7c50e28d-07cc-a4cf-740f-c8f33d52e13d"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "1978-05-08T10:07:21+00:00",
        "end": "1979-05-08T10:07:21+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-8d60-a1b6cf4b7f8c"
        },
        "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:7c50e28d-07cc-a4cf-4571-a47ea67ed41d"
        },
        "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"
          } ]
        }
      }, {
        "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"
          } ]
        }
      } ],
      "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:7c50e28d-07cc-a4cf-e890-6bb2744b788c",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e890-6bb2744b788c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "1979-04-23T09:32:32+00:00",
        "end": "1979-04-23T10:29:42+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0c3a-5e79b28f4755",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-0c3a-5e79b28f4755",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "266934004",
          "display": "Transport problem (finding)"
        } ],
        "text": "Transport problem (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e890-6bb2744b788c"
      },
      "onsetDateTime": "1979-04-23T10:29:42+00:00",
      "assertedDate": "1979-04-23T10:29:42+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9afc-d6e7755881f9",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-9afc-d6e7755881f9",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1979-04-23T09:32:32+00:00",
        "end": "1979-04-23T10:29:42+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0c3a-5e79b28f4755"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e890-6bb2744b788c"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:f99d9ab1-5d23-5f49-4123-557334b23af7",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "f99d9ab1-5d23-5f49-4123-557334b23af7",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999994491"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-9afc-d6e7755881f9"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1979-04-23T10:29:42+00:00",
        "end": "1980-04-23T10:29:42+00:00"
      },
      "created": "1979-04-23T10:29:42+00:00",
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9afc-d6e7755881f9"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-0c3a-5e79b28f4755"
        },
        "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": "1979-04-23T09:32:32+00:00",
          "end": "1979-04-23T10:29:42+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:7c50e28d-07cc-a4cf-e890-6bb2744b788c"
        } ],
        "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": "1979-04-23T09:32:32+00:00",
          "end": "1979-04-23T10:29:42+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 881.47,
        "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:7c50e28d-07cc-a4cf-1899-e03205adb29d",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-1899-e03205adb29d",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "50849002",
          "display": "Emergency room admission (procedure)"
        } ],
        "text": "Emergency room admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "1990-01-31T09:32:32+00:00",
        "end": "1990-01-31T10:32:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "124171000119105",
          "display": "Chronic intractable migraine without aura (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6717-48284f3092f6",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-6717-48284f3092f6",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "124171000119105",
          "display": "Chronic intractable migraine without aura (disorder)"
        } ],
        "text": "Chronic intractable migraine without aura (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1899-e03205adb29d"
      },
      "onsetDateTime": "1990-01-31T09:32:32+00:00",
      "assertedDate": "1990-01-31T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5138-5ecb991b5074",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-5138-5ecb991b5074",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1990-01-31T09:32:32+00:00",
        "end": "1990-01-31T10:32:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6717-48284f3092f6"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-1899-e03205adb29d"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c6032603-b46a-e472-f3d5-34c02c8505c8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c6032603-b46a-e472-f3d5-34c02c8505c8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicaid"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-5138-5ecb991b5074"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1990-01-31T10:32:32+00:00",
        "end": "1991-01-31T10:32:32+00:00"
      },
      "created": "1990-01-31T10:32:32+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5138-5ecb991b5074"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-6717-48284f3092f6"
        },
        "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": "1990-01-31T09:32:32+00:00",
          "end": "1990-01-31T10:32:32+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-1899-e03205adb29d"
        } ],
        "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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": "1990-01-31T09:32:32+00:00",
          "end": "1990-01-31T10:32:32+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5593-eb279348599e",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-5593-eb279348599e",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "50849002",
          "display": "Emergency room admission (procedure)"
        } ],
        "text": "Emergency room admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "1990-03-09T09:32:32+00:00",
        "end": "1990-03-09T10:32:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "196416002",
          "display": "Impacted molars (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f30b-0a58dd73efd6",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-f30b-0a58dd73efd6",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "196416002",
          "display": "Impacted molars (disorder)"
        } ],
        "text": "Impacted molars (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5593-eb279348599e"
      },
      "onsetDateTime": "1990-03-09T09:32:32+00:00",
      "assertedDate": "1990-03-09T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5164-f4d2f11ca236",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-5164-f4d2f11ca236",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1990-03-09T09:32:32+00:00",
        "end": "1990-03-09T10:32:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f30b-0a58dd73efd6"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5593-eb279348599e"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:00bf3c32-f717-3edb-369c-5d1ebe991093",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "00bf3c32-f717-3edb-369c-5d1ebe991093",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Medicaid"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-5164-f4d2f11ca236"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1990-03-09T10:32:32+00:00",
        "end": "1991-03-09T10:32:32+00:00"
      },
      "created": "1990-03-09T10:32:32+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5164-f4d2f11ca236"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-f30b-0a58dd73efd6"
        },
        "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": "1990-03-09T09:32:32+00:00",
          "end": "1990-03-09T10:32:32+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5593-eb279348599e"
        } ],
        "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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": "1990-03-09T09:32:32+00:00",
          "end": "1990-03-09T10:32:32+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 5308.14,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d757-340790b001b8",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-d757-340790b001b8",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "183452005",
          "display": "Emergency hospital admission (procedure)"
        } ],
        "text": "Emergency hospital admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "1990-10-08T09:32:32+00:00",
        "end": "1990-10-08T10:32:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "82423001",
          "display": "Chronic pain (finding)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4d1b-8ed1790edfb1",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-4d1b-8ed1790edfb1",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-d757-340790b001b8"
      },
      "onsetDateTime": "1990-10-08T09:32:32+00:00",
      "assertedDate": "1990-10-08T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4e01-3bdd9dfaf15c",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-4e01-3bdd9dfaf15c",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1990-10-08T09:32:32+00:00",
        "end": "1990-10-08T10:32:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4d1b-8ed1790edfb1"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 87.71,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d757-340790b001b8"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 87.71,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:02b4739a-2745-ab87-bd76-4b292d0d9138",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "02b4739a-2745-ab87-bd76-4b292d0d9138",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-4e01-3bdd9dfaf15c"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1990-10-08T10:32:32+00:00",
        "end": "1991-10-08T10:32:32+00:00"
      },
      "created": "1990-10-08T10:32:32+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4e01-3bdd9dfaf15c"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-4d1b-8ed1790edfb1"
        },
        "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": "1990-10-08T09:32:32+00:00",
          "end": "1990-10-08T10:32:32+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 87.71,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d757-340790b001b8"
        } ],
        "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": 17.541999999999998,
            "system": "urn: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": 70.16799999999999,
            "system": "urn: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": 87.71,
            "system": "urn: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": 87.71,
            "system": "urn: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": "1990-10-08T09:32:32+00:00",
          "end": "1990-10-08T10:32:32+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 87.71,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 70.16799999999999,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0e3e-af1e561eb596",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-0e3e-af1e561eb596",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "1991-05-27T09:32:32+00:00",
        "end": "1991-05-27T10:16:45+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-86ef-a9f06bb1235b",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-86ef-a9f06bb1235b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0e3e-af1e561eb596"
      },
      "onsetDateTime": "1991-05-27T09:32:32+00:00",
      "assertedDate": "1991-05-27T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2c16-b43d5b217beb",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-2c16-b43d5b217beb",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1991-05-27T09:32:32+00:00",
        "end": "1991-05-27T10:16:45+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-86ef-a9f06bb1235b"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0e3e-af1e561eb596"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:bba5eb25-36bc-0554-03e0-dd063a128bcc",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "bba5eb25-36bc-0554-03e0-dd063a128bcc",
      "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": "7c50e28d-07cc-a4cf-2c16-b43d5b217beb"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "1991-05-27T10:16:45+00:00",
        "end": "1992-05-27T10:16:45+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-86ef-a9f06bb1235b"
        },
        "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:7c50e28d-07cc-a4cf-e406-1cea7b8a6380",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e406-1cea7b8a6380",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "305408004",
          "display": "Admission to surgical department (procedure)"
        } ],
        "text": "Admission to surgical department (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "1995-06-23T10:32:52+00:00",
        "end": "1995-06-24T10:32:52+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "183996000",
          "display": "Sterilization requested (situation)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e434-cc1b2edffa41",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-e434-cc1b2edffa41",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "267020005",
          "display": "History of tubal ligation (situation)"
        } ],
        "text": "History of tubal ligation (situation)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e406-1cea7b8a6380"
      },
      "onsetDateTime": "1995-06-23T12:44:52+00:00",
      "assertedDate": "1995-06-23T12:44:52+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-84df-f5794332d33f",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-84df-f5794332d33f",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "1995-06-23T10:32:52+00:00",
        "end": "1995-06-24T10:32:52+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e434-cc1b2edffa41"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e406-1cea7b8a6380"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:b38f3cb9-5461-a9d0-4c94-5da51bed32f6",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "b38f3cb9-5461-a9d0-4c94-5da51bed32f6",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-ime-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-dsh-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pass-thru-per-diem-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-clm-tot-pps-cptl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-ip-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-pta-coinsrnc-lblty-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-ncvrd-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-tot-ddctn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-dsprprtnt-shr-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-excptn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-fsp-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-ime-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-outlier-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-old-cptl-hld-hrmls-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-drg-outlier-aprvd-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-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-inpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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": "7c50e28d-07cc-a4cf-84df-f5794332d33f"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "1995-06-24T10:32:52+00:00",
        "end": "1996-06-24T10:32:52+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-e434-cc1b2edffa41"
        },
        "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-inpatient-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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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-inpatient-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": 6872.72,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-17da-94444856a6c8",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-17da-94444856a6c8",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2002-03-25T09:32:32+00:00",
        "end": "2002-03-25T10:25:59+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-653e-b8e5eb3c653e",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-653e-b8e5eb3c653e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-17da-94444856a6c8"
      },
      "onsetDateTime": "2002-03-25T10:25:59+00:00",
      "abatementDateTime": "2014-04-07T10:14:14+00:00",
      "assertedDate": "2002-03-25T10:25:59+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8c18-5ec366d374a8",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-8c18-5ec366d374a8",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2002-03-25T09:32:32+00:00",
        "end": "2002-03-25T10:25:59+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-653e-b8e5eb3c653e"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-17da-94444856a6c8"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7dc4f4b6-c06d-bac9-6faa-f1073c250304",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "7dc4f4b6-c06d-bac9-6faa-f1073c250304",
      "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": "7c50e28d-07cc-a4cf-8c18-5ec366d374a8"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2002-03-25T10:25:59+00:00",
        "end": "2003-03-25T10:25:59+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-653e-b8e5eb3c653e"
        },
        "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": 1541.85,
        "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:7c50e28d-07cc-a4cf-4276-c30b88fcf013",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-4276-c30b88fcf013",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "56876005",
          "display": "Drug rehabilitation and detoxification (regime/therapy)"
        } ],
        "text": "Drug rehabilitation and detoxification (regime/therapy)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2003-12-30T09:32:32+00:00",
        "end": "2004-01-21T09:32:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-5581-dc9fcba63636",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ],
        "text": "Dependent drug abuse (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4276-c30b88fcf013"
      },
      "onsetDateTime": "2003-12-30T09:32:32+00:00",
      "assertedDate": "2003-12-30T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-dea9-8770ad350ffb",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-dea9-8770ad350ffb",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2003-12-30T09:32:32+00:00",
        "end": "2004-01-21T09:32:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4276-c30b88fcf013"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:527e14e4-1d91-c802-6169-1c425a6b455d",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "527e14e4-1d91-c802-6169-1c425a6b455d",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-ime-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-dsh-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pass-thru-per-diem-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-clm-tot-pps-cptl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-ip-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-pta-coinsrnc-lblty-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-ncvrd-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-tot-ddctn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-dsprprtnt-shr-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-excptn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-fsp-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-ime-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-outlier-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-old-cptl-hld-hrmls-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-drg-outlier-aprvd-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-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-inpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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": "7c50e28d-07cc-a4cf-dea9-8770ad350ffb"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2004-01-21T09:32:32+00:00",
        "end": "2005-01-21T09:32:32+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-5581-dc9fcba63636"
        },
        "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-inpatient-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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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-inpatient-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": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6b63-b31a75e57b3a",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-6b63-b31a75e57b3a",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2004-03-29T09:32:32+00:00",
        "end": "2004-03-29T10:05:40+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-344e-9f94fd821afb",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-344e-9f94fd821afb",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6b63-b31a75e57b3a"
      },
      "onsetDateTime": "2004-03-29T09:32:32+00:00",
      "abatementDateTime": "2010-07-19T09:32:32+00:00",
      "assertedDate": "2004-03-29T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-522f-b4fb726e6c27",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-522f-b4fb726e6c27",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2004-03-29T09:32:32+00:00",
        "end": "2004-03-29T10:05:40+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-344e-9f94fd821afb"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6b63-b31a75e57b3a"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 136.80,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:dbf54a34-a23a-6f64-c2de-2cd29982aa56",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "dbf54a34-a23a-6f64-c2de-2cd29982aa56",
      "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": "7c50e28d-07cc-a4cf-522f-b4fb726e6c27"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2004-03-29T10:05:40+00:00",
        "end": "2005-03-29T10:05:40+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-344e-9f94fd821afb"
        },
        "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:7c50e28d-07cc-a4cf-8ea7-3696cf452b8d",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-8ea7-3696cf452b8d",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "50849002",
          "display": "Emergency room admission (procedure)"
        } ],
        "text": "Emergency room admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "2004-12-30T14:36:42+00:00",
        "end": "2004-12-31T07:36:42+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d4fe-4cf5f1969df0",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-d4fe-4cf5f1969df0",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ],
        "text": "Overdose (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-8ea7-3696cf452b8d"
      },
      "onsetDateTime": "2004-12-30T14:36:42+00:00",
      "abatementDateTime": "2004-12-31T07:36:42+00:00",
      "assertedDate": "2004-12-30T14:36:42+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9bd5-1cccdad222dc",
    "resource": {
      "resourceType": "CarePlan",
      "id": "7c50e28d-07cc-a4cf-9bd5-1cccdad222dc",
      "status": "active",
      "intent": "order",
      "category": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "734163000",
          "display": "Care plan (record artifact)"
        } ],
        "text": "Care plan (record artifact)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-8ea7-3696cf452b8d"
      },
      "period": {
        "start": "2004-12-31T07:36:42+00:00"
      },
      "activity": [ {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "60112009",
              "display": "Drug addiction counseling (procedure)"
            } ],
            "text": "Drug addiction counseling (procedure)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "61480009",
              "display": "Drug detoxification (regime/therapy)"
            } ],
            "text": "Drug detoxification (regime/therapy)"
          },
          "status": "in-progress"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "266707007",
              "display": "Drug addiction therapy (regime/therapy)"
            } ],
            "text": "Drug addiction therapy (regime/therapy)"
          },
          "status": "in-progress"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "CarePlan"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e077-133d48bba65b",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-e077-133d48bba65b",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2004-12-30T14:36:42+00:00",
        "end": "2004-12-31T07:36:42+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d4fe-4cf5f1969df0"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8ea7-3696cf452b8d"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c7bcb577-57db-ae19-25f9-9db08eecb921",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c7bcb577-57db-ae19-25f9-9db08eecb921",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "NO_INSURANCE"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-e077-133d48bba65b"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2004-12-31T07:36:42+00:00",
        "end": "2005-12-31T07:36:42+00:00"
      },
      "created": "2004-12-31T07:36:42+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e077-133d48bba65b"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-d4fe-4cf5f1969df0"
        },
        "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": "2004-12-30T14:36:42+00:00",
          "end": "2004-12-31T07:36:42+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8ea7-3696cf452b8d"
        } ],
        "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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": "2004-12-30T14:36:42+00:00",
          "end": "2004-12-31T07:36:42+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f15b-b1ef1671e4b2",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-f15b-b1ef1671e4b2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2005-02-11T07:36:42+00:00",
        "end": "2005-02-11T08:54:54+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5088-303a4c0ffd50",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-5088-303a4c0ffd50",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-f15b-b1ef1671e4b2"
      },
      "performedPeriod": {
        "start": "2005-02-11T07:36:42+00:00",
        "end": "2005-02-11T08:54:54+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5ee1-7bd9509eb5f8",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-5ee1-7bd9509eb5f8",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2005-02-11T07:36:42+00:00",
        "end": "2005-02-11T08:54:54+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5088-303a4c0ffd50"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f15b-b1ef1671e4b2"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:cd63ca91-8c9b-6816-311b-f6af058f0fdb",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "cd63ca91-8c9b-6816-311b-f6af058f0fdb",
      "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": "7c50e28d-07cc-a4cf-5ee1-7bd9509eb5f8"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2005-02-11T08:54:54+00:00",
        "end": "2006-02-11T08:54:54+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ddd1-fff04eeea58d",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-ddd1-fff04eeea58d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2005-11-13T08:54:54+00:00",
        "end": "2005-11-13T09:58:26+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6c38-a886eb99a67d",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-6c38-a886eb99a67d",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ddd1-fff04eeea58d"
      },
      "performedPeriod": {
        "start": "2005-11-13T08:54:54+00:00",
        "end": "2005-11-13T09:58:26+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0017-15e0feed4992",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-0017-15e0feed4992",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2005-11-13T08:54:54+00:00",
        "end": "2005-11-13T09:58:26+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6c38-a886eb99a67d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ddd1-fff04eeea58d"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:4b30e92f-8273-094f-cc39-cc54062227c9",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "4b30e92f-8273-094f-cc39-cc54062227c9",
      "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": "7c50e28d-07cc-a4cf-0017-15e0feed4992"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2005-11-13T09:58:26+00:00",
        "end": "2006-11-13T09:58:26+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6ff0-0c512567b2f0",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-6ff0-0c512567b2f0",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2005-12-13T09:58:26+00:00",
        "end": "2005-12-13T10:58:38+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7c27-4a61955cd25e",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-7c27-4a61955cd25e",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6ff0-0c512567b2f0"
      },
      "performedPeriod": {
        "start": "2005-12-13T09:58:26+00:00",
        "end": "2005-12-13T10:58:38+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4c30-d6f0361e5fb2",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-4c30-d6f0361e5fb2",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2005-12-13T09:58:26+00:00",
        "end": "2005-12-13T10:58:38+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c27-4a61955cd25e"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6ff0-0c512567b2f0"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:aa931d92-1e74-21fa-88a1-cbbe3bed15d3",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "aa931d92-1e74-21fa-88a1-cbbe3bed15d3",
      "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": "7c50e28d-07cc-a4cf-4c30-d6f0361e5fb2"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2005-12-13T10:58:38+00:00",
        "end": "2006-12-13T10:58:38+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0fa9-e66d107b5b17",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-0fa9-e66d107b5b17",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-01-12T10:58:38+00:00",
        "end": "2006-01-12T12:15:24+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-efb9-e349cc717d75",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-efb9-e349cc717d75",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0fa9-e66d107b5b17"
      },
      "performedPeriod": {
        "start": "2006-01-12T10:58:38+00:00",
        "end": "2006-01-12T12:15:24+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-aadd-206d3ea3ae5c",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-aadd-206d3ea3ae5c",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-01-12T10:58:38+00:00",
        "end": "2006-01-12T12:15:24+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-efb9-e349cc717d75"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0fa9-e66d107b5b17"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:87102bca-2575-5621-3786-0f999c444d86",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "87102bca-2575-5621-3786-0f999c444d86",
      "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": "7c50e28d-07cc-a4cf-aadd-206d3ea3ae5c"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-01-12T12:15:24+00:00",
        "end": "2007-01-12T12:15:24+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-462d-0bc7470f9758",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-462d-0bc7470f9758",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-02-11T12:15:24+00:00",
        "end": "2006-02-11T13:41:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e358-3e0688d41f3e",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-e358-3e0688d41f3e",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-462d-0bc7470f9758"
      },
      "performedPeriod": {
        "start": "2006-02-11T12:15:24+00:00",
        "end": "2006-02-11T13:41:32+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-336d-a5e6d175ebc1",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-336d-a5e6d175ebc1",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-02-11T12:15:24+00:00",
        "end": "2006-02-11T13:41:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e358-3e0688d41f3e"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-462d-0bc7470f9758"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:0c65e762-8e81-d78d-bb84-63b3cb4d2c10",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "0c65e762-8e81-d78d-bb84-63b3cb4d2c10",
      "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": "7c50e28d-07cc-a4cf-336d-a5e6d175ebc1"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-02-11T13:41:32+00:00",
        "end": "2007-02-11T13:41:32+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-31d5-5c1edbf89baa",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-31d5-5c1edbf89baa",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-03-13T13:41:32+00:00",
        "end": "2006-03-13T15:02:23+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-63b3-f169b4e586df",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-63b3-f169b4e586df",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-31d5-5c1edbf89baa"
      },
      "performedPeriod": {
        "start": "2006-03-13T13:41:32+00:00",
        "end": "2006-03-13T15:02:23+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6200-148b8a7bee41",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-6200-148b8a7bee41",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-03-13T13:41:32+00:00",
        "end": "2006-03-13T15:02:23+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-63b3-f169b4e586df"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-31d5-5c1edbf89baa"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:a1cc1acd-86bb-a17d-3f4d-68a83731854d",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "a1cc1acd-86bb-a17d-3f4d-68a83731854d",
      "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": "7c50e28d-07cc-a4cf-6200-148b8a7bee41"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-03-13T15:02:23+00:00",
        "end": "2007-03-13T15:02:23+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2006-04-03T09:32:32+00:00",
        "end": "2006-04-03T10:19:30+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d22c-5d76459e007c",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-d22c-5d76459e007c",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "422650009",
          "display": "Social isolation (finding)"
        } ],
        "text": "Social isolation (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "onsetDateTime": "2006-04-03T10:19:30+00:00",
      "abatementDateTime": "2008-04-07T10:24:05+00:00",
      "assertedDate": "2006-04-03T10:19:30+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4aca-054918fd219f",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-4aca-054918fd219f",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73595000",
          "display": "Stress (finding)"
        } ],
        "text": "Stress (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "onsetDateTime": "2006-04-03T10:19:30+00:00",
      "abatementDateTime": "2008-04-07T10:24:05+00:00",
      "assertedDate": "2006-04-03T10:19:30+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-629f-8804ed17773a",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-629f-8804ed17773a",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-856d-87bd83fe280f",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-856d-87bd83fe280f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e626-d106c7841498",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-e626-d106c7841498",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 71.100,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-06b8-aef29573bc33",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-06b8-aef29573bc33",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 27.600,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f8b9-267122ae3f6e",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-f8b9-267122ae3f6e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 78,
          "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": 118,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e1c7-406b1c296323",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-e1c7-406b1c296323",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 70,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-16ef-eb5c1fa662ae",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-16ef-eb5c1fa662ae",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ab75-a0f8bd4353dd",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-ab75-a0f8bd4353dd",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 185.32,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3e5c-433846195089",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3e5c-433846195089",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 109.17,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f2f5-62257098db03",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-f2f5-62257098db03",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 108.90,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-cc9f-294a147e804b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-cc9f-294a147e804b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 54.580,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-542e-f9985405f386",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-542e-f9985405f386",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 6.8171,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6385-1ecd56abc514",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6385-1ecd56abc514",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 5.0258,
        "unit": "10*6/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*6/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e4fe-d329f36334f7",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-e4fe-d329f36334f7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 13.971,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3a20-d5a1c578e7e3",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3a20-d5a1c578e7e3",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 36.939,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-31bd-63b9b77c1908",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-31bd-63b9b77c1908",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 80.188,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b622-4b35fab3dbb7",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b622-4b35fab3dbb7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 27.272,
        "unit": "pg",
        "system": "http://unitsofmeasure.org",
        "code": "pg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2da9-e3177d74534b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-2da9-e3177d74534b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 35.242,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e6ae-1fc3fdb50546",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-e6ae-1fc3fdb50546",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 41.174,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1c1c-3685e7b7a9b9",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-1c1c-3685e7b7a9b9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 303.20,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-10da-843953a11de9",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-10da-843953a11de9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 10.658,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0519-ab3f8edc5d2f",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-0519-ab3f8edc5d2f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 11.252,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2cc5-1cb8b939a420",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-2cc5-1cb8b939a420",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+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:7c50e28d-07cc-a4cf-9b75-b0b08d08bc51",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9b75-b0b08d08bc51",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T10:19:30+00:00",
      "issued": "2006-04-03T10:19:30.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA27722-0",
            "display": "Less than once a week"
          } ],
          "text": "Less than once 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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-f3bf-4dda47a567fe",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-f3bf-4dda47a567fe",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "performedPeriod": {
        "start": "2006-04-03T09:32:32+00:00",
        "end": "2006-04-03T10:19:30+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0484-3f54805de634",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-0484-3f54805de634",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "date": "2006-04-03T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-88c6-04b00d7b82b6",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-88c6-04b00d7b82b6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ab75-a0f8bd4353dd",
        "display": "Cholesterol [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e5c-433846195089",
        "display": "Triglyceride [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-f2f5-62257098db03",
        "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-cc9f-294a147e804b",
        "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0123-463dc766af3e",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-0123-463dc766af3e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
      },
      "effectiveDateTime": "2006-04-03T09:32:32+00:00",
      "issued": "2006-04-03T09:32:32.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-542e-f9985405f386",
        "display": "Leukocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6385-1ecd56abc514",
        "display": "Erythrocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e4fe-d329f36334f7",
        "display": "Hemoglobin [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3a20-d5a1c578e7e3",
        "display": "Hematocrit [Volume Fraction] of Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-31bd-63b9b77c1908",
        "display": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-b622-4b35fab3dbb7",
        "display": "MCH [Entitic mass] by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-2da9-e3177d74534b",
        "display": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e6ae-1fc3fdb50546",
        "display": "Erythrocyte [DistWidth] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1c1c-3685e7b7a9b9",
        "display": "Platelets [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-10da-843953a11de9",
        "display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0519-ab3f8edc5d2f",
        "display": "Platelet [Entitic mean volume] in Blood by Automated count"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1c33-9f3584e1b5d2",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-1c33-9f3584e1b5d2",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-04-03T09:32:32+00:00",
        "end": "2006-04-03T10:19:30+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0484-3f54805de634"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-d22c-5d76459e007c"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4aca-054918fd219f"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f3bf-4dda47a567fe"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a7a-07fb1bf75eaa"
        } ]
      }, {
        "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,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 7,
        "diagnosisLinkId": [ 2 ]
      } ],
      "total": {
        "value": 853.36,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ffa73301-ae73-cd1f-0705-6ffc5d0bd409",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "ffa73301-ae73-cd1f-0705-6ffc5d0bd409",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-1c33-9f3584e1b5d2"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-04-03T10:19:30+00:00",
        "end": "2007-04-03T10:19:30+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-d22c-5d76459e007c"
        },
        "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:7c50e28d-07cc-a4cf-4aca-054918fd219f"
        },
        "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": 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,
        "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": 7,
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "22",
            "display": "Outpatient Hospital"
          } ]
        }
      } ],
      "totalCost": {
        "value": 853.36,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 682.688,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5395-55c64ed82bf7",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-5395-55c64ed82bf7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-04-12T15:02:23+00:00",
        "end": "2006-04-12T16:04:18+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2147-2a6333ebf681",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-2147-2a6333ebf681",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5395-55c64ed82bf7"
      },
      "performedPeriod": {
        "start": "2006-04-12T15:02:23+00:00",
        "end": "2006-04-12T16:04:18+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-dfd2-5c643d4ab8b2",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-dfd2-5c643d4ab8b2",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-04-12T15:02:23+00:00",
        "end": "2006-04-12T16:04:18+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-2147-2a6333ebf681"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5395-55c64ed82bf7"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c6e6bdb3-4aae-cd99-b31d-5793b6cc468d",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c6e6bdb3-4aae-cd99-b31d-5793b6cc468d",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-dfd2-5c643d4ab8b2"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-04-12T16:04:18+00:00",
        "end": "2007-04-12T16:04:18+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-542e-89b73cad14a0",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-542e-89b73cad14a0",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-05-12T16:04:18+00:00",
        "end": "2006-05-12T17:15:05+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-581d-2a00af12ba40",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-581d-2a00af12ba40",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-542e-89b73cad14a0"
      },
      "performedPeriod": {
        "start": "2006-05-12T16:04:18+00:00",
        "end": "2006-05-12T17:15:05+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e9e1-de750d0d3ab6",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-e9e1-de750d0d3ab6",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-05-12T16:04:18+00:00",
        "end": "2006-05-12T17:15:05+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-581d-2a00af12ba40"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-542e-89b73cad14a0"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c8467b8d-c6e7-0d29-0338-636fdf924972",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c8467b8d-c6e7-0d29-0338-636fdf924972",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-e9e1-de750d0d3ab6"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-05-12T17:15:05+00:00",
        "end": "2007-05-12T17:15:05+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9be2-ecb9c6070549",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-9be2-ecb9c6070549",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-06-11T17:15:05+00:00",
        "end": "2006-06-11T18:40:34+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b3d8-bc5dc97428e2",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-b3d8-bc5dc97428e2",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9be2-ecb9c6070549"
      },
      "performedPeriod": {
        "start": "2006-06-11T17:15:05+00:00",
        "end": "2006-06-11T18:40:34+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2ee9-6ba593f5ca4c",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-2ee9-6ba593f5ca4c",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-06-11T17:15:05+00:00",
        "end": "2006-06-11T18:40:34+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b3d8-bc5dc97428e2"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-9be2-ecb9c6070549"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:947f8dca-233d-6736-50f9-88bb4c63d945",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "947f8dca-233d-6736-50f9-88bb4c63d945",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-2ee9-6ba593f5ca4c"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-06-11T18:40:34+00:00",
        "end": "2007-06-11T18:40:34+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e48a-f468bb2a5645",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e48a-f468bb2a5645",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2006-07-11T18:40:34+00:00",
        "end": "2006-07-11T20:04:02+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c4e8-f09f20719939",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-c4e8-f09f20719939",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e48a-f468bb2a5645"
      },
      "performedPeriod": {
        "start": "2006-07-11T18:40:34+00:00",
        "end": "2006-07-11T20:04:02+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a6da-425cb01002e3",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-a6da-425cb01002e3",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2006-07-11T18:40:34+00:00",
        "end": "2006-07-11T20:04:02+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c4e8-f09f20719939"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e48a-f468bb2a5645"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:d007250d-29d4-7ecb-2319-33c9a3d1db29",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "d007250d-29d4-7ecb-2319-33c9a3d1db29",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-a6da-425cb01002e3"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2006-07-11T20:04:02+00:00",
        "end": "2007-07-11T20:04:02+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0c9e-fb7ffcb49144",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-0c9e-fb7ffcb49144",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2007-03-01T20:04:02+00:00",
        "end": "2007-03-01T21:29:48+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-113f-60d862c4060f",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-113f-60d862c4060f",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0c9e-fb7ffcb49144"
      },
      "performedPeriod": {
        "start": "2007-03-01T20:04:02+00:00",
        "end": "2007-03-01T21:29:48+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b6dc-15b26e07759f",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-b6dc-15b26e07759f",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2007-03-01T20:04:02+00:00",
        "end": "2007-03-01T21:29:48+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-113f-60d862c4060f"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0c9e-fb7ffcb49144"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:706517ed-86b5-23ad-f14e-c756372b077d",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "706517ed-86b5-23ad-f14e-c756372b077d",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-b6dc-15b26e07759f"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2007-03-01T21:29:48+00:00",
        "end": "2008-03-01T21:29:48+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ca05-06d316daff8d",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-ca05-06d316daff8d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2007-03-31T21:29:48+00:00",
        "end": "2007-03-31T22:57:26+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-66cd-e2a284468906",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-66cd-e2a284468906",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ca05-06d316daff8d"
      },
      "performedPeriod": {
        "start": "2007-03-31T21:29:48+00:00",
        "end": "2007-03-31T22:57:26+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f7d7-29f904f73828",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-f7d7-29f904f73828",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2007-03-31T21:29:48+00:00",
        "end": "2007-03-31T22:57:26+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-66cd-e2a284468906"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ca05-06d316daff8d"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:62fe1305-6771-b8b0-f4a9-1a63a47afce5",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "62fe1305-6771-b8b0-f4a9-1a63a47afce5",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-f7d7-29f904f73828"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2007-03-31T22:57:26+00:00",
        "end": "2008-03-31T22:57:26+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b799-d72415e6f035",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-b799-d72415e6f035",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2007-04-30T22:57:26+00:00",
        "end": "2007-05-01T00:23:21+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0294-d0f35821e4a6",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-0294-d0f35821e4a6",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-b799-d72415e6f035"
      },
      "performedPeriod": {
        "start": "2007-04-30T22:57:26+00:00",
        "end": "2007-05-01T00:23:21+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-29ef-9df2a721e67b",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-29ef-9df2a721e67b",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2007-04-30T22:57:26+00:00",
        "end": "2007-05-01T00:23:21+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0294-d0f35821e4a6"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b799-d72415e6f035"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:3b0639ab-52aa-d20d-64ed-880a7ec84b01",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "3b0639ab-52aa-d20d-64ed-880a7ec84b01",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-29ef-9df2a721e67b"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2007-05-01T00:23:21+00:00",
        "end": "2008-05-01T00:23:21+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9f46-096d4c21ad38",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-9f46-096d4c21ad38",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2007-05-31T00:23:21+00:00",
        "end": "2007-05-31T01:35:49+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7e2b-499ad51688a1",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-7e2b-499ad51688a1",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9f46-096d4c21ad38"
      },
      "performedPeriod": {
        "start": "2007-05-31T00:23:21+00:00",
        "end": "2007-05-31T01:35:49+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3ea6-2d2a9cf23690",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-3ea6-2d2a9cf23690",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2007-05-31T00:23:21+00:00",
        "end": "2007-05-31T01:35:49+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7e2b-499ad51688a1"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-9f46-096d4c21ad38"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:9e557de9-cc05-3a83-1439-4ea4c2ecce34",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "9e557de9-cc05-3a83-1439-4ea4c2ecce34",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-3ea6-2d2a9cf23690"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2007-05-31T01:35:49+00:00",
        "end": "2008-05-31T01:35:49+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8347-627290152456",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-8347-627290152456",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2007-06-30T01:35:49+00:00",
        "end": "2007-06-30T03:03:27+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f230-1a91f9822d6d",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-f230-1a91f9822d6d",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-8347-627290152456"
      },
      "performedPeriod": {
        "start": "2007-06-30T01:35:49+00:00",
        "end": "2007-06-30T03:03:27+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-cfb1-5734453bd798",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-cfb1-5734453bd798",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2007-06-30T01:35:49+00:00",
        "end": "2007-06-30T03:03:27+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f230-1a91f9822d6d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8347-627290152456"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:32f84c99-2627-7c08-fa99-e9373d669cf3",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "32f84c99-2627-7c08-fa99-e9373d669cf3",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-cfb1-5734453bd798"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2007-06-30T03:03:27+00:00",
        "end": "2008-06-30T03:03:27+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a9b9-d4525f6dc750",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-a9b9-d4525f6dc750",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2007-07-30T03:03:27+00:00",
        "end": "2007-07-30T04:09:07+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6b16-3a2dbcb0b867",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-6b16-3a2dbcb0b867",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-a9b9-d4525f6dc750"
      },
      "performedPeriod": {
        "start": "2007-07-30T03:03:27+00:00",
        "end": "2007-07-30T04:09:07+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7590-7547297b3b3a",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-7590-7547297b3b3a",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2007-07-30T03:03:27+00:00",
        "end": "2007-07-30T04:09:07+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6b16-3a2dbcb0b867"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-a9b9-d4525f6dc750"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:a17a7be8-1ae0-e287-a49b-67afbca4345f",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "a17a7be8-1ae0-e287-a49b-67afbca4345f",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-7590-7547297b3b3a"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2007-07-30T04:09:07+00:00",
        "end": "2008-07-30T04:09:07+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-3e7a-de43680f87fe",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2008-04-07T09:32:32+00:00",
        "end": "2008-04-07T10:24:05+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-00dd-a62e50c26be6",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-00dd-a62e50c26be6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9925-0171e3b4a690",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9925-0171e3b4a690",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 4,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3624-1ef5dbed2ee6",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3624-1ef5dbed2ee6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 73.900,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7553-3a808b03aa45",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-7553-3a808b03aa45",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 28.710,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-098e-3226aa3fdd8f",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-098e-3226aa3fdd8f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 75,
          "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:7c50e28d-07cc-a4cf-abf6-f2a3a43be31a",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-abf6-f2a3a43be31a",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 78,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0d7f-33a50f346385",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-0d7f-33a50f346385",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-923a-b3c9e8f3a51b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-923a-b3c9e8f3a51b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T09:32:32+00:00",
      "issued": "2008-04-07T09:32:32.196+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:7c50e28d-07cc-a4cf-4d7c-a28449724659",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4d7c-a28449724659",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T10:24:05+00:00",
      "issued": "2008-04-07T10:24:05.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-1426-329fe8e01d5e",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-1426-329fe8e01d5e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T10:43:30+00:00",
      "issued": "2008-04-07T10:43:30.196+00:00",
      "valueQuantity": {
        "value": 7,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4a31-754a3b6c113a",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4a31-754a3b6c113a",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T11:08:58+00:00",
      "issued": "2008-04-07T11:08:58.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4b55-f08f81a109f7",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-4b55-f08f81a109f7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "performedPeriod": {
        "start": "2008-04-07T09:32:32+00:00",
        "end": "2008-04-07T10:24:05+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e134-c96e08b27575",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-e134-c96e08b27575",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "performedPeriod": {
        "start": "2008-04-07T10:24:05+00:00",
        "end": "2008-04-07T10:43:30+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8eb5-58f401f1b7f4",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-8eb5-58f401f1b7f4",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "performedPeriod": {
        "start": "2008-04-07T10:43:30+00:00",
        "end": "2008-04-07T11:08:58+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c08d-438228c209c6",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-c08d-438228c209c6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "date": "2008-04-07T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-92fd-b7f21c8c4bcc",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-92fd-b7f21c8c4bcc",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T10:43:30+00:00",
      "issued": "2008-04-07T10:43:30.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1426-329fe8e01d5e",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b38e-2b63b4282293",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-b38e-2b63b4282293",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
      },
      "effectiveDateTime": "2008-04-07T11:08:58+00:00",
      "issued": "2008-04-07T11:08:58.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4a31-754a3b6c113a",
        "display": "Total score [HARK]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-81c8-d251592e00c3",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-81c8-d251592e00c3",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2008-04-07T09:32:32+00:00",
        "end": "2008-04-07T10:24:05+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c08d-438228c209c6"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4b55-f08f81a109f7"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e134-c96e08b27575"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8eb5-58f401f1b7f4"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3e7a-de43680f87fe"
        } ]
      }, {
        "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": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "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": 5,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "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": "866148006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 1716.16,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7e4a2ce9-d816-2403-9f35-f48ce031ade0",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "7e4a2ce9-d816-2403-9f35-f48ce031ade0",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-81c8-d251592e00c3"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2008-04-07T10:24:05+00:00",
        "end": "2009-04-07T10:24:05+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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": "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": 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": "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": 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": "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": 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"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 704.20,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1372.928,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2beb-7e34e65fde0e",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-2beb-7e34e65fde0e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2008-10-22T04:09:07+00:00",
        "end": "2008-10-22T05:13:39+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-96a1-37427f83a9b2",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-96a1-37427f83a9b2",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-2beb-7e34e65fde0e"
      },
      "performedPeriod": {
        "start": "2008-10-22T04:09:07+00:00",
        "end": "2008-10-22T05:13:39+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5f7f-2c522483f856",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-5f7f-2c522483f856",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2008-10-22T04:09:07+00:00",
        "end": "2008-10-22T05:13:39+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-96a1-37427f83a9b2"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-2beb-7e34e65fde0e"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:4d40f950-4e2e-21df-6d76-dbbda935801c",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "4d40f950-4e2e-21df-6d76-dbbda935801c",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-5f7f-2c522483f856"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2008-10-22T05:13:39+00:00",
        "end": "2009-10-22T05:13:39+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7c2d-44bd21bb3e51",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-7c2d-44bd21bb3e51",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2008-11-21T05:13:39+00:00",
        "end": "2008-11-21T06:34:20+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ca7b-566f16da0fb0",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ca7b-566f16da0fb0",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c2d-44bd21bb3e51"
      },
      "performedPeriod": {
        "start": "2008-11-21T05:13:39+00:00",
        "end": "2008-11-21T06:34:20+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b8e0-34ab696759c1",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-b8e0-34ab696759c1",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2008-11-21T05:13:39+00:00",
        "end": "2008-11-21T06:34:20+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ca7b-566f16da0fb0"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c2d-44bd21bb3e51"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:06032623-a823-9ab3-54b5-34e02266715f",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "06032623-a823-9ab3-54b5-34e02266715f",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-b8e0-34ab696759c1"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2008-11-21T06:34:20+00:00",
        "end": "2009-11-21T06:34:20+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2beb-9b754926cb57",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-2beb-9b754926cb57",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "56876005",
          "display": "Drug rehabilitation and detoxification (regime/therapy)"
        } ],
        "text": "Drug rehabilitation and detoxification (regime/therapy)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2009-05-03T06:34:20+00:00",
        "end": "2009-05-10T06:34:20+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-79fc-079734a5ab0b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-79fc-079734a5ab0b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-2beb-9b754926cb57"
      },
      "effectiveDateTime": "2009-05-03T06:34:20+00:00",
      "issued": "2009-05-03T06:34:20.196+00:00",
      "valueQuantity": {
        "value": 5,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1a0d-524caba0cd84",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-1a0d-524caba0cd84",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2009-05-03T06:34:20+00:00",
        "end": "2009-05-10T06:34:20+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-2beb-9b754926cb57"
        } ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7cfe886c-ab56-9ae0-02d3-0c1bc9ea9842",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "7cfe886c-ab56-9ae0-02d3-0c1bc9ea9842",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-ime-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-dsh-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pass-thru-per-diem-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-clm-tot-pps-cptl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-ip-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-pta-coinsrnc-lblty-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-ncvrd-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-tot-ddctn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-dsprprtnt-shr-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-excptn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-fsp-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-ime-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-outlier-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-old-cptl-hld-hrmls-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-drg-outlier-aprvd-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-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-inpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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": "7c50e28d-07cc-a4cf-1a0d-524caba0cd84"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2009-05-10T06:34:20+00:00",
        "end": "2010-05-10T06:34:20+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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-inpatient-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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4e34-ac4426852e3c",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-4e34-ac4426852e3c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-01-24T06:34:20+00:00",
        "end": "2010-01-24T07:45:57+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7fa7-61d3e6277c63",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-7fa7-61d3e6277c63",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4e34-ac4426852e3c"
      },
      "performedPeriod": {
        "start": "2010-01-24T06:34:20+00:00",
        "end": "2010-01-24T07:45:57+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ad34-73676c2d21b8",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-ad34-73676c2d21b8",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-01-24T06:34:20+00:00",
        "end": "2010-01-24T07:45:57+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7fa7-61d3e6277c63"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4e34-ac4426852e3c"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:519d1699-29a5-968f-00bb-aff066c36b13",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "519d1699-29a5-968f-00bb-aff066c36b13",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-ad34-73676c2d21b8"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-01-24T07:45:57+00:00",
        "end": "2011-01-24T07:45:57+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-df2a-8d698330f00e",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-df2a-8d698330f00e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-02-23T07:45:57+00:00",
        "end": "2010-02-23T08:53:58+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a49a-5690c95bec4e",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-a49a-5690c95bec4e",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-df2a-8d698330f00e"
      },
      "performedPeriod": {
        "start": "2010-02-23T07:45:57+00:00",
        "end": "2010-02-23T08:53:58+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1bc6-5301122b1c87",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-1bc6-5301122b1c87",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-02-23T07:45:57+00:00",
        "end": "2010-02-23T08:53:58+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-a49a-5690c95bec4e"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-df2a-8d698330f00e"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:06987f91-94e8-c219-031c-2eb02edabf90",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "06987f91-94e8-c219-031c-2eb02edabf90",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-1bc6-5301122b1c87"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-02-23T08:53:58+00:00",
        "end": "2011-02-23T08:53:58+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2010-03-15T09:32:32+00:00",
        "end": "2010-03-15T10:25:11+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3631-1d266dda056c",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-3631-1d266dda056c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "onsetDateTime": "2010-03-15T10:25:11+00:00",
      "abatementDateTime": "2010-07-19T10:13:45+00:00",
      "assertedDate": "2010-03-15T10:25:11+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3af3-156943c62dda",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-3af3-156943c62dda",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73595000",
          "display": "Stress (finding)"
        } ],
        "text": "Stress (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "onsetDateTime": "2010-03-15T10:25:11+00:00",
      "abatementDateTime": "2012-11-19T10:15:43+00:00",
      "assertedDate": "2010-03-15T10:25:11+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8dea-2e5e241cb735",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-8dea-2e5e241cb735",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "706893006",
          "display": "Victim of intimate partner abuse (finding)"
        } ],
        "text": "Victim of intimate partner abuse (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "onsetDateTime": "2010-03-15T10:25:11+00:00",
      "abatementDateTime": "2010-07-19T10:13:45+00:00",
      "assertedDate": "2010-03-15T10:25:11+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c4da-b22c6293c27b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-c4da-b22c6293c27b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6ef0-c6df24f6ff33",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6ef0-c6df24f6ff33",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6c4a-fa73e3e3bd17",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6c4a-fa73e3e3bd17",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 77.400,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4fbd-73c37d41dcce",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4fbd-73c37d41dcce",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 30.040,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-fc7f-afaa2ba68d78",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-fc7f-afaa2ba68d78",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 78,
          "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": 121,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6e4c-b0b0cdab205c",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6e4c-b0b0cdab205c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 66,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5c8d-fb5bddffbe2c",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-5c8d-fb5bddffbe2c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4d1d-2767aebd2e8e",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4d1d-2767aebd2e8e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 165.92,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ecf8-cb2d2f56b934",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-ecf8-cb2d2f56b934",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 110,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6fe5-e579e16cde1b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6fe5-e579e16cde1b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 98.190,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4e08-8118b7cab65b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4e08-8118b7cab65b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 45.730,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-af6c-e1b57aca5ddd",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-af6c-e1b57aca5ddd",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+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:7c50e28d-07cc-a4cf-594a-5c858cbd56cb",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-594a-5c858cbd56cb",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T10:25:11+00:00",
      "issued": "2010-03-15T10:25:11.196+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": "LA33-6",
            "display": "Yes"
          } ],
          "text": "Yes"
        }
      }, {
        "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": "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": "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": "LA13902-4",
            "display": "Quite a bit"
          } ],
          "text": "Quite a 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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-e590-272200b73c1f",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-e590-272200b73c1f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "performedPeriod": {
        "start": "2010-03-15T09:32:32+00:00",
        "end": "2010-03-15T10:25:11+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5095-06264a0e3d4d",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-5095-06264a0e3d4d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "performedPeriod": {
        "start": "2010-03-15T10:25:11+00:00",
        "end": "2010-03-15T10:34:26+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b12d-5746dc43fee8",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-b12d-5746dc43fee8",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "121",
          "display": "zoster vaccine, live"
        } ],
        "text": "zoster vaccine, live"
      },
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "date": "2010-03-15T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-42b4-2bcd98914613",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-42b4-2bcd98914613",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "date": "2010-03-15T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-dbbd-ea0e90c696af",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-dbbd-ea0e90c696af",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
      },
      "effectiveDateTime": "2010-03-15T09:32:32+00:00",
      "issued": "2010-03-15T09:32:32.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4d1d-2767aebd2e8e",
        "display": "Cholesterol [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ecf8-cb2d2f56b934",
        "display": "Triglyceride [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6fe5-e579e16cde1b",
        "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4e08-8118b7cab65b",
        "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-026c-b299c2d5c16a",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-026c-b299c2d5c16a",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-03-15T09:32:32+00:00",
        "end": "2010-03-15T10:25:11+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b12d-5746dc43fee8"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-42b4-2bcd98914613"
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3631-1d266dda056c"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3af3-156943c62dda"
        }
      }, {
        "sequence": 3,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8dea-2e5e241cb735"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e590-272200b73c1f"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5095-06264a0e3d4d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee3f-b67f6dae3a9b"
        } ]
      }, {
        "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,
        "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,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 7,
        "diagnosisLinkId": [ 2 ]
      }, {
        "sequence": 8,
        "diagnosisLinkId": [ 3 ]
      }, {
        "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": "103697008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 1346.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:b0652a55-941a-0404-1f15-a03967652fcc",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "b0652a55-941a-0404-1f15-a03967652fcc",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-026c-b299c2d5c16a"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-03-15T10:25:11+00:00",
        "end": "2011-03-15T10:25:11+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-3631-1d266dda056c"
        },
        "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:7c50e28d-07cc-a4cf-3af3-156943c62dda"
        },
        "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:7c50e28d-07cc-a4cf-8dea-2e5e241cb735"
        },
        "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"
          } ]
        },
        "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,
        "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": 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,
        "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": "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": 914.78,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1076.944,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e655-78e6c42fcaf3",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-03-29T09:32:32+00:00",
        "end": "2010-03-29T13:14:18+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "103697008",
          "display": "Patient referral for dental care (procedure)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-61c2-63ef9a33b4c4",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-61c2-63ef9a33b4c4",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T09:32:32+00:00",
        "end": "2010-03-29T10:14:34+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1b16-a43085a98dde",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-1b16-a43085a98dde",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T10:14:34+00:00",
        "end": "2010-03-29T10:43:23+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ed31-67e7940b1578",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ed31-67e7940b1578",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T10:43:23+00:00",
        "end": "2010-03-29T11:28:05+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-902f-daec3f2a9d2b",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-902f-daec3f2a9d2b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T11:28:05+00:00",
        "end": "2010-03-29T12:05:58+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ca77-72e2d6edf628",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ca77-72e2d6edf628",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T12:05:58+00:00",
        "end": "2010-03-29T12:41:40+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0143-b93e6390b585",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-0143-b93e6390b585",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T12:41:40+00:00",
        "end": "2010-03-29T13:03:35+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c3cf-540f8d8e7c83",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-c3cf-540f8d8e7c83",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "performedPeriod": {
        "start": "2010-03-29T13:03:35+00:00",
        "end": "2010-03-29T13:14:18+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-aae3-848234871cc0",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "7c50e28d-07cc-a4cf-aae3-848234871cc0",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "authoredOn": "2010-03-29T12:41:40+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
          "display": "TEWKSBURY HOSPITAL"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d148-76e16e7446a6",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-d148-76e16e7446a6",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-03-29T09:32:32+00:00",
        "end": "2010-03-29T13:14:18+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "prescription": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-aae3-848234871cc0"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
        } ]
      } ],
      "total": {
        "value": 129.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:51c0e2ef-80cd-121f-f3e5-4e84047c30b9",
    "resource": {
      "resourceType": "MedicationAdministration",
      "id": "51c0e2ef-80cd-121f-f3e5-4e84047c30b9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
      },
      "effectiveDateTime": "2010-03-29T12:41:40+00:00"
    },
    "request": {
      "method": "POST",
      "url": "MedicationAdministration"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5803-e30dd79aecd3",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-5803-e30dd79aecd3",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-03-29T10:43:23+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3169-a00f651cea1e",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-3169-a00f651cea1e",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-03-29T10:43:23+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-de4b-629c80482591",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-de4b-629c80482591",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-03-29T10:43:23+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f672-2bb684a4fd69",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-f672-2bb684a4fd69",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-03-29T09:32:32+00:00",
        "end": "2010-03-29T13:14:18+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "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"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-61c2-63ef9a33b4c4"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-1b16-a43085a98dde"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ed31-67e7940b1578"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-902f-daec3f2a9d2b"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ca77-72e2d6edf628"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0143-b93e6390b585"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c3cf-540f8d8e7c83"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e655-78e6c42fcaf3"
        } ]
      }, {
        "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,
        "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": "68071007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "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": "243085009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3105.35,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:6fbff73a-1abd-7894-8734-2e8255af623e",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "6fbff73a-1abd-7894-8734-2e8255af623e",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-f672-2bb684a4fd69"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-03-29T13:14:18+00:00",
        "end": "2011-03-29T13:14:18+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "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,
        "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": 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": "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": 3105.35,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2484.2799999999997,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6cd3-3357d1897d01",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-6cd3-3357d1897d01",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-04-05T09:32:32+00:00",
        "end": "2010-04-05T10:45:01+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c2b5-86db21400d25",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-c2b5-86db21400d25",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6cd3-3357d1897d01"
      },
      "performedPeriod": {
        "start": "2010-04-05T09:32:32+00:00",
        "end": "2010-04-05T10:45:01+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4ba3-bcd91ae986a8",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-4ba3-bcd91ae986a8",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-04-05T09:32:32+00:00",
        "end": "2010-04-05T10:45:01+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c2b5-86db21400d25"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6cd3-3357d1897d01"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:9965e745-f9f7-744a-a883-b954b671df60",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "9965e745-f9f7-744a-a883-b954b671df60",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-4ba3-bcd91ae986a8"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-04-05T10:45:01+00:00",
        "end": "2011-04-05T10:45:01+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e6db-76a144d4e616",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e6db-76a144d4e616",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-05-05T10:45:01+00:00",
        "end": "2010-05-05T11:47:58+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ee9d-3518069b248a",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ee9d-3518069b248a",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e6db-76a144d4e616"
      },
      "performedPeriod": {
        "start": "2010-05-05T10:45:01+00:00",
        "end": "2010-05-05T11:47:58+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d946-6feb6376f808",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-d946-6feb6376f808",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-05-05T10:45:01+00:00",
        "end": "2010-05-05T11:47:58+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ee9d-3518069b248a"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e6db-76a144d4e616"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:4da7b4a1-817b-6b2e-2537-0251a3f149f0",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "4da7b4a1-817b-6b2e-2537-0251a3f149f0",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-d946-6feb6376f808"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-05-05T11:47:58+00:00",
        "end": "2011-05-05T11:47:58+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-587a-b16f22c30a90",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-587a-b16f22c30a90",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-06-04T11:47:58+00:00",
        "end": "2010-06-04T12:52:12+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-175d-bf3e920ba2fb",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-175d-bf3e920ba2fb",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-587a-b16f22c30a90"
      },
      "performedPeriod": {
        "start": "2010-06-04T11:47:58+00:00",
        "end": "2010-06-04T12:52:12+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d536-61a865dcd11e",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-d536-61a865dcd11e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-06-04T11:47:58+00:00",
        "end": "2010-06-04T12:52:12+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-175d-bf3e920ba2fb"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-587a-b16f22c30a90"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:c52436c1-e795-0938-611f-34178c18b857",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "c52436c1-e795-0938-611f-34178c18b857",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-d536-61a865dcd11e"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-06-04T12:52:12+00:00",
        "end": "2011-06-04T12:52:12+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c81f-ba595644a352",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-c81f-ba595644a352",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-07-04T12:52:12+00:00",
        "end": "2010-07-04T14:00:50+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3cd6-235710f678f0",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-3cd6-235710f678f0",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-c81f-ba595644a352"
      },
      "performedPeriod": {
        "start": "2010-07-04T12:52:12+00:00",
        "end": "2010-07-04T14:00:50+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-285e-30f4ddd885e4",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-285e-30f4ddd885e4",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-07-04T12:52:12+00:00",
        "end": "2010-07-04T14:00:50+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3cd6-235710f678f0"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c81f-ba595644a352"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:52d759da-c1df-8509-7173-ef91ae3408b8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "52d759da-c1df-8509-7173-ef91ae3408b8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-285e-30f4ddd885e4"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-07-04T14:00:50+00:00",
        "end": "2011-07-04T14:00:50+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-81a6-720aca7147b9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-07-19T09:32:32+00:00",
        "end": "2010-07-19T10:13:45+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-7407-37d9af236840",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ],
        "text": "Gingivitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "onsetDateTime": "2010-07-19T10:53:29+00:00",
      "abatementDateTime": "2010-08-02T11:41:32+00:00",
      "assertedDate": "2010-07-19T10:53:29+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a550-7044e24bd8e4",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-a550-7044e24bd8e4",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3f2f-f7b7d2627153",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3f2f-f7b7d2627153",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 4,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c842-0d0756e89e26",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-c842-0d0756e89e26",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 76.100,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-52ec-6fbfb836fb03",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-52ec-6fbfb836fb03",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 29.560,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d0f4-b0546a75b9db",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d0f4-b0546a75b9db",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 77,
          "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": 115,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d441-84c811fce913",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d441-84c811fce913",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 66,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6dcc-10ab8c916bc5",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6dcc-10ab8c916bc5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e6b2-fa790a0d62cd",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-e6b2-fa790a0d62cd",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T09:32:32+00:00",
      "issued": "2010-07-19T09:32:32.196+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:7c50e28d-07cc-a4cf-03b1-d2c3e2f985ca",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-03b1-d2c3e2f985ca",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T10:13:45+00:00",
      "issued": "2010-07-19T10:13:45.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA13914-9",
            "display": "Very much"
          } ],
          "text": "Very much"
        }
      }, {
        "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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-ed61-032a4a2182ad",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-ed61-032a4a2182ad",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T10:53:29+00:00",
      "issued": "2010-07-19T10:53:29.196+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-faba-be1f34bc560f",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-faba-be1f34bc560f",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "performedPeriod": {
        "start": "2010-07-19T09:32:32+00:00",
        "end": "2010-07-19T09:47:32+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b966-45f61f60d322",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-b966-45f61f60d322",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "performedPeriod": {
        "start": "2010-07-19T09:32:32+00:00",
        "end": "2010-07-19T10:13:45+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6be9-c8903ee73046",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-6be9-c8903ee73046",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "performedPeriod": {
        "start": "2010-07-19T10:13:45+00:00",
        "end": "2010-07-19T10:26:20+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-523d-243f49a3c07c",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-523d-243f49a3c07c",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "performedPeriod": {
        "start": "2010-07-19T10:26:20+00:00",
        "end": "2010-07-19T10:53:29+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-db06-5734603fc6be",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-db06-5734603fc6be",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "performedPeriod": {
        "start": "2010-07-19T10:53:29+00:00",
        "end": "2010-07-19T10:58:29+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b090-cb2643450fd5",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-b090-cb2643450fd5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "date": "2010-07-19T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c89a-9699bebbab1b",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-c89a-9699bebbab1b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
      },
      "effectiveDateTime": "2010-07-19T10:53:29+00:00",
      "issued": "2010-07-19T10:53:29.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ed61-032a4a2182ad",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ddf1-2e85ed76503e",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-ddf1-2e85ed76503e",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-07-19T09:32:32+00:00",
        "end": "2010-07-19T10:13:45+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b090-cb2643450fd5"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-faba-be1f34bc560f"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b966-45f61f60d322"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6be9-c8903ee73046"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-523d-243f49a3c07c"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-db06-5734603fc6be"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 3,
        "procedureLinkId": [ 1 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "net": {
          "value": 862.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "procedureLinkId": [ 2 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "procedureLinkId": [ 3 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "procedureLinkId": [ 4 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 9,
        "procedureLinkId": [ 5 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "103697008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 2884.53,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:fc75ca9f-4194-563d-f891-76bcba893d4f",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "fc75ca9f-4194-563d-f891-76bcba893d4f",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999994491"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-ddf1-2e85ed76503e"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-07-19T10:13:45+00:00",
        "end": "2011-07-19T10:13:45+00:00"
      },
      "created": "2010-07-19T10:13:45+00:00",
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ddf1-2e85ed76503e"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-7407-37d9af236840"
        },
        "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": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+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:7c50e28d-07cc-a4cf-81a6-720aca7147b9"
        } ],
        "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,
        "informationLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+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"
            } ]
          }
        } ]
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "430193006"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 862.80,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 7,
        "informationLinkId": [ 2 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 74.58,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 8,
        "diagnosisLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        }
      }, {
        "sequence": 9,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "103697008"
          } ]
        },
        "servicedPeriod": {
          "start": "2010-07-19T09:32:32+00:00",
          "end": "2010-07-19T10:13:45+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "21",
            "display": "Inpatient Hospital"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1515.75,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2307.624,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d5ed-9693cf83b288",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-d5ed-9693cf83b288",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-07-26T09:32:32+00:00",
        "end": "2010-07-26T09:47:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "444814009",
          "display": "Viral sinusitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c7c2-930af1b63b7e",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-c7c2-930af1b63b7e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-d5ed-9693cf83b288"
      },
      "onsetDateTime": "2010-07-26T09:32:32+00:00",
      "abatementDateTime": "2010-08-14T09:32:32+00:00",
      "assertedDate": "2010-07-26T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9141-d1b9c04e97fc",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "7c50e28d-07cc-a4cf-9141-d1b9c04e97fc",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-d5ed-9693cf83b288"
      },
      "authoredOn": "2010-07-26T09:32:32+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
          "display": "TEWKSBURY HOSPITAL"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-c7c2-930af1b63b7e"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3f7e-c763eb6cffbd",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-3f7e-c763eb6cffbd",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-07-26T09:32:32+00:00",
        "end": "2010-07-26T09:47:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "prescription": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9141-d1b9c04e97fc"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d5ed-9693cf83b288"
        } ]
      } ],
      "total": {
        "value": 172.14,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c052-2ea42c58bc50",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-c052-2ea42c58bc50",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-07-26T09:32:32+00:00",
        "end": "2010-07-26T09:47:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c7c2-930af1b63b7e"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d5ed-9693cf83b288"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:8b19827a-eba3-eaae-62a8-d0fe11a7a570",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "8b19827a-eba3-eaae-62a8-d0fe11a7a570",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-c052-2ea42c58bc50"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-07-26T09:47:32+00:00",
        "end": "2011-07-26T09:47:32+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-c7c2-930af1b63b7e"
        },
        "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:7c50e28d-07cc-a4cf-950d-3ddd6e779f16",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-950d-3ddd6e779f16",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-08-02T09:32:32+00:00",
        "end": "2010-08-02T12:25:06+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-eac4-4857935e5e70",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-eac4-4857935e5e70",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T09:32:32+00:00",
        "end": "2010-08-02T10:10:45+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-315f-3895c8b3fd2d",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-315f-3895c8b3fd2d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T10:10:45+00:00",
        "end": "2010-08-02T10:31:59+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-fd7f-0a77102560e3",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-fd7f-0a77102560e3",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T10:31:59+00:00",
        "end": "2010-08-02T10:48:46+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c502-e960d7e1d202",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-c502-e960d7e1d202",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T10:48:46+00:00",
        "end": "2010-08-02T11:11:32+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-30be-9cca817f0014",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-30be-9cca817f0014",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T11:11:32+00:00",
        "end": "2010-08-02T11:41:32+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2d3d-390960628190",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-2d3d-390960628190",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T11:41:32+00:00",
        "end": "2010-08-02T12:09:43+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-bdb4-30c975a14d98",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-bdb4-30c975a14d98",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "performedPeriod": {
        "start": "2010-08-02T12:09:43+00:00",
        "end": "2010-08-02T12:25:06+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-cc68-762309219b75",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "7c50e28d-07cc-a4cf-cc68-762309219b75",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "authoredOn": "2010-08-02T11:41:32+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
          "display": "TEWKSBURY HOSPITAL"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f274-8862e5ddab46",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-f274-8862e5ddab46",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-08-02T09:32:32+00:00",
        "end": "2010-08-02T12:25:06+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "prescription": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-cc68-762309219b75"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
        } ]
      } ],
      "total": {
        "value": 129.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ccde59d8-cd7b-0577-b8a6-012381247a98",
    "resource": {
      "resourceType": "MedicationAdministration",
      "id": "ccde59d8-cd7b-0577-b8a6-012381247a98",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
      },
      "effectiveDateTime": "2010-08-02T11:41:32+00:00",
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationAdministration"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-64bc-2f36c3d3be72",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-64bc-2f36c3d3be72",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-08-02T10:31:59+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5de9-2a16714c0368",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-5de9-2a16714c0368",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-08-02T10:31:59+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3bbe-eee5ec5de325",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-3bbe-eee5ec5de325",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-08-02T10:31:59+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-12e9-ce250710e0ed",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-12e9-ce250710e0ed",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-08-02T09:32:32+00:00",
        "end": "2010-08-02T12:25:06+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "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"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eac4-4857935e5e70"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-315f-3895c8b3fd2d"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-fd7f-0a77102560e3"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c502-e960d7e1d202"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-30be-9cca817f0014"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-2d3d-390960628190"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-bdb4-30c975a14d98"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-950d-3ddd6e779f16"
        } ]
      }, {
        "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,
        "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": "68071007"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 11,
        "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": "243085009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3105.35,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:4a199b25-52c2-724b-336c-5f80fedfeb40",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "4a199b25-52c2-724b-336c-5f80fedfeb40",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-12e9-ce250710e0ed"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-08-02T12:25:06+00:00",
        "end": "2011-08-02T12:25:06+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "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,
        "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": 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": "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": 3105.35,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2484.2799999999997,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5fcd-da67d549edb8",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-5fcd-da67d549edb8",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-08-03T14:00:50+00:00",
        "end": "2010-08-03T15:03:20+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a821-bf20eb8e331c",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-a821-bf20eb8e331c",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5fcd-da67d549edb8"
      },
      "performedPeriod": {
        "start": "2010-08-03T14:00:50+00:00",
        "end": "2010-08-03T15:03:20+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9eee-f8f2f03a22c5",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-9eee-f8f2f03a22c5",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-08-03T14:00:50+00:00",
        "end": "2010-08-03T15:03:20+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-a821-bf20eb8e331c"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5fcd-da67d549edb8"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:22b5855d-a06a-7421-4577-5cecef02ae66",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "22b5855d-a06a-7421-4577-5cecef02ae66",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-9eee-f8f2f03a22c5"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-08-03T15:03:20+00:00",
        "end": "2011-08-03T15:03:20+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-86da-791be74f84ad",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-86da-791be74f84ad",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-09-02T15:03:20+00:00",
        "end": "2010-09-02T16:29:13+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7575-e5b572a8282a",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-7575-e5b572a8282a",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-86da-791be74f84ad"
      },
      "performedPeriod": {
        "start": "2010-09-02T15:03:20+00:00",
        "end": "2010-09-02T16:29:13+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-027f-ec171c369893",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-027f-ec171c369893",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-09-02T15:03:20+00:00",
        "end": "2010-09-02T16:29:13+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7575-e5b572a8282a"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-86da-791be74f84ad"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:bba4da4f-51e0-fe48-03df-cc392e93c6f4",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "bba4da4f-51e0-fe48-03df-cc392e93c6f4",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-027f-ec171c369893"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-09-02T16:29:13+00:00",
        "end": "2011-09-02T16:29:13+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7cec-684de6755371",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-7cec-684de6755371",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2010-10-02T16:29:13+00:00",
        "end": "2010-10-02T17:50:55+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0432-1191b2844f4f",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-0432-1191b2844f4f",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7cec-684de6755371"
      },
      "performedPeriod": {
        "start": "2010-10-02T16:29:13+00:00",
        "end": "2010-10-02T17:50:55+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-511a-5a61862cbb08",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-511a-5a61862cbb08",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2010-10-02T16:29:13+00:00",
        "end": "2010-10-02T17:50:55+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0432-1191b2844f4f"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7cec-684de6755371"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:92d170f3-4f7b-85a7-76a5-3db28def361d",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "92d170f3-4f7b-85a7-76a5-3db28def361d",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-511a-5a61862cbb08"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2010-10-02T17:50:55+00:00",
        "end": "2011-10-02T17:50:55+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e28d-76cd706f0842",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2011-03-21T09:32:32+00:00",
        "end": "2011-03-21T10:15:28+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-10dc-751bd91479b1",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-10dc-751bd91479b1",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "onsetDateTime": "2011-03-21T09:32:32+00:00",
      "abatementDateTime": "2012-03-26T09:32:32+00:00",
      "assertedDate": "2011-03-21T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-7c75-b5d18850b414",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ],
        "text": "Gingivitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "onsetDateTime": "2011-03-21T12:00:23+00:00",
      "abatementDateTime": "2011-04-04T15:39:05+00:00",
      "assertedDate": "2011-03-21T12:00:23+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b55d-50e879ee6029",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b55d-50e879ee6029",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8a77-e47a789f09b6",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-8a77-e47a789f09b6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d35f-e998b5614f97",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d35f-e998b5614f97",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 71,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9810-be88686b9ec2",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9810-be88686b9ec2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 27.580,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-493a-75edebd2d383",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-493a-75edebd2d383",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 82,
          "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": 116,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9421-5934900e55a7",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9421-5934900e55a7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 96,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2712-90e6fb627ef9",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-2712-90e6fb627ef9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b072-146d481cfc7d",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b072-146d481cfc7d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T09:32:32+00:00",
      "issued": "2011-03-21T09:32:32.196+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:7c50e28d-07cc-a4cf-858d-d553606924d6",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-858d-d553606924d6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T10:15:28+00:00",
      "issued": "2011-03-21T10:15:28.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-3384-3b8bf83f309b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3384-3b8bf83f309b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T10:43:35+00:00",
      "issued": "2011-03-21T10:43:35.196+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a220-8ec09ae610b7",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-a220-8ec09ae610b7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T11:19:23+00:00",
      "issued": "2011-03-21T11:19:23.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d10d-e6710f4fb127",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d10d-e6710f4fb127",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T12:00:23+00:00",
      "issued": "2011-03-21T12:00:23.196+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9a42-b653e817d64b",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-9a42-b653e817d64b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "performedPeriod": {
        "start": "2011-03-21T09:32:32+00:00",
        "end": "2011-03-21T10:15:28+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6cf2-5b207a479bb6",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-6cf2-5b207a479bb6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "performedPeriod": {
        "start": "2011-03-21T10:15:28+00:00",
        "end": "2011-03-21T10:43:35+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-03a2-d8520d7246bb",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-03a2-d8520d7246bb",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "performedPeriod": {
        "start": "2011-03-21T10:43:35+00:00",
        "end": "2011-03-21T11:19:23+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-869a-b4e1df2cf130",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-869a-b4e1df2cf130",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "performedPeriod": {
        "start": "2011-03-21T11:19:23+00:00",
        "end": "2011-03-21T11:31:43+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b5f4-864c6888d8e5",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-b5f4-864c6888d8e5",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "performedPeriod": {
        "start": "2011-03-21T11:31:43+00:00",
        "end": "2011-03-21T12:00:23+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2a89-98964e8443e0",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-2a89-98964e8443e0",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "performedPeriod": {
        "start": "2011-03-21T12:00:23+00:00",
        "end": "2011-03-21T12:10:08+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-953b-955d9be54b0e",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-953b-955d9be54b0e",
      "status": "completed",
      "notGiven": false,
      "vaccineCode": {
        "coding": [ {
          "system": "http://hl7.org/fhir/sid/cvx",
          "code": "121",
          "display": "zoster vaccine, live"
        } ],
        "text": "zoster vaccine, live"
      },
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "date": "2011-03-21T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c852-902e32af0068",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-c852-902e32af0068",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "date": "2011-03-21T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9e98-74d880e81312",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-9e98-74d880e81312",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "date": "2011-03-21T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a5b2-0ff87b26d4c9",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-a5b2-0ff87b26d4c9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T10:43:35+00:00",
      "issued": "2011-03-21T10:43:35.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3384-3b8bf83f309b",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e4cf-999d4d9c03fb",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-e4cf-999d4d9c03fb",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T11:19:23+00:00",
      "issued": "2011-03-21T11:19:23.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-a220-8ec09ae610b7",
        "display": "Total score [HARK]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-de30-0d6096a94e11",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-de30-0d6096a94e11",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
      },
      "effectiveDateTime": "2011-03-21T12:00:23+00:00",
      "issued": "2011-03-21T12:00:23.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-d10d-e6710f4fb127",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ec7f-35a578af0783",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-ec7f-35a578af0783",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-03-21T09:32:32+00:00",
        "end": "2011-03-21T10:15:28+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-953b-955d9be54b0e"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c852-902e32af0068"
        }
      }, {
        "sequence": 3,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-9e98-74d880e81312"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-10dc-751bd91479b1"
        }
      }, {
        "sequence": 2,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-9a42-b653e817d64b"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6cf2-5b207a479bb6"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-03a2-d8520d7246bb"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-869a-b4e1df2cf130"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b5f4-864c6888d8e5"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-2a89-98964e8443e0"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e28d-76cd706f0842"
        } ]
      }, {
        "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,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 136.00,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 6,
        "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": 7,
        "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": 8,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 9,
        "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": "866148006"
          } ]
        },
        "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": [ 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": 12,
        "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": 13,
        "informationLinkId": [ 6 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 14,
        "diagnosisLinkId": [ 2 ]
      }, {
        "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": "103697008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3356.94,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:884793f5-291d-bad0-7a31-b0f48215030b",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "884793f5-291d-bad0-7a31-b0f48215030b",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-ec7f-35a578af0783"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-03-21T10:15:28+00:00",
        "end": "2012-03-21T10:15:28+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-10dc-751bd91479b1"
        },
        "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:7c50e28d-07cc-a4cf-7c75-b5d18850b414"
        },
        "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"
          } ]
        },
        "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": 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,
        "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": "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": "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": 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,
        "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,
        "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": 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": "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": 976.20,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2685.552,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-ec93-fc8a72fce75a",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2011-04-04T09:32:32+00:00",
        "end": "2011-04-04T15:44:09+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "66383009",
          "display": "Gingivitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-53b6-a81bb5c12f49",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-53b6-a81bb5c12f49",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "onsetDateTime": "2011-04-04T12:36:29+00:00",
      "abatementDateTime": "2011-04-04T15:08:08+00:00",
      "assertedDate": "2011-04-04T12:36:29+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3399-9492b5e87bc7",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-3399-9492b5e87bc7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T09:32:32+00:00",
        "end": "2011-04-04T10:00:23+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-40db-6c50a97557ea",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-40db-6c50a97557ea",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T10:00:23+00:00",
        "end": "2011-04-04T10:47:43+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-fea0-9d71acfc898c",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-fea0-9d71acfc898c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T10:47:43+00:00",
        "end": "2011-04-04T11:08:48+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-de91-dc601099778d",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-de91-dc601099778d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T11:08:48+00:00",
        "end": "2011-04-04T11:38:26+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f75e-322f203b0a5a",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-f75e-322f203b0a5a",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "241046008",
          "display": "Dental plain X-ray bitewing (procedure)"
        } ],
        "text": "Dental plain X-ray bitewing (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T11:38:26+00:00",
        "end": "2011-04-04T12:08:26+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8bf2-3e20e8d513ae",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-8bf2-3e20e8d513ae",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T11:38:26+00:00",
        "end": "2011-04-04T12:36:29+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8175-95528254df00",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-8175-95528254df00",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T12:36:29+00:00",
        "end": "2011-04-04T12:41:29+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-53b6-a81bb5c12f49",
        "display": "Gingival disease (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-883d-68892a85a23f",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-883d-68892a85a23f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T12:41:29+00:00",
        "end": "2011-04-04T14:19:49+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-53b6-a81bb5c12f49",
        "display": "Gingival disease (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-afe1-ad18bd383c99",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-afe1-ad18bd383c99",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T14:19:49+00:00",
        "end": "2011-04-04T15:08:08+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-53b6-a81bb5c12f49",
        "display": "Gingival disease (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2105-63b96e8cc781",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-2105-63b96e8cc781",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T15:08:08+00:00",
        "end": "2011-04-04T15:39:05+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0f5d-8c83ecda7c4f",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-0f5d-8c83ecda7c4f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "performedPeriod": {
        "start": "2011-04-04T15:39:05+00:00",
        "end": "2011-04-04T15:44:09+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7407-37d9af236840",
        "display": "Gingivitis (disorder)"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7c75-b5d18850b414",
        "display": "Gingivitis (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d339-1f0ce75503bd",
    "resource": {
      "resourceType": "ImagingStudy",
      "id": "7c50e28d-07cc-a4cf-d339-1f0ce75503bd",
      "uid": "urn:oid:1.2.840.99999999.84680753.1301917106196",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
      },
      "started": "2011-04-04T11:38:26+00:00",
      "numberOfSeries": 1,
      "numberOfInstances": 1,
      "procedureCode": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "241046008",
          "display": "Dental plain X-ray bitewing (procedure)"
        } ],
        "text": "Dental plain X-ray bitewing (procedure)"
      } ],
      "series": [ {
        "uid": "urn:oid:1.2.840.99999999.1.66608643.1301917106196",
        "number": 1,
        "modality": {
          "system": "http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html",
          "code": "DX",
          "display": "Digital Radiography"
        },
        "numberOfInstances": 1,
        "availability": "UNAVAILABLE",
        "bodySite": {
          "system": "http://snomed.info/sct",
          "code": "700016008",
          "display": "Structure of region of internal part of mouth (body structure)"
        },
        "started": "2011-04-04T11:38:26+00:00",
        "instance": [ {
          "uid": "urn:oid:1.2.840.99999999.1.1.93421347.1301917106196",
          "number": 1,
          "sopClass": "urn:oid:1.2.840.10008.5.1.4.1.1.1.3",
          "title": "Digital Intra-Oral X-Ray Image"
        } ]
      } ]
    },
    "request": {
      "method": "POST",
      "url": "ImagingStudy"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1759-d2b60b94c6f1",
    "resource": {
      "resourceType": "Device",
      "id": "7c50e28d-07cc-a4cf-1759-d2b60b94c6f1",
      "udi": {
        "deviceIdentifier": "13340401518956",
        "carrierHRF": "(01)13340401518956(11)110314(17)360328(10)6149653536872488(21)45135859868"
      },
      "status": "active",
      "type": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "706298007",
          "display": "Dental x-ray system (physical object)"
        } ],
        "text": "Dental x-ray system (physical object)"
      },
      "lotNumber": "6149653536872488",
      "manufactureDate": "2011-03-14T11:38:26+00:00",
      "expirationDate": "2036-03-28T11:38:26+00:00",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      }
    },
    "request": {
      "method": "POST",
      "url": "Device"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5507-363aabdceb32",
    "resource": {
      "resourceType": "Device",
      "id": "7c50e28d-07cc-a4cf-5507-363aabdceb32",
      "udi": {
        "deviceIdentifier": "48793731020166",
        "carrierHRF": "(01)48793731020166(11)110314(17)360328(10)194043559725798(21)3581276"
      },
      "status": "active",
      "type": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "225738002",
          "display": "Operating room (environment)"
        } ],
        "text": "Operating room (environment)"
      },
      "lotNumber": "194043559725798",
      "manufactureDate": "2011-03-14T12:36:29+00:00",
      "expirationDate": "2036-03-28T12:36:29+00:00",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      }
    },
    "request": {
      "method": "POST",
      "url": "Device"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7476-96ff9efd069a",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-7476-96ff9efd069a",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-04-04T10:47:43+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c0ed-aa461bf37724",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-c0ed-aa461bf37724",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-04-04T10:47:43+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1eb6-6894be77822c",
    "resource": {
      "resourceType": "SupplyDelivery",
      "id": "7c50e28d-07cc-a4cf-1eb6-6894be77822c",
      "status": "completed",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-04-04T10:47:43+00:00"
    },
    "request": {
      "method": "POST",
      "url": "SupplyDelivery"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c83c-c4392293a162",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-c83c-c4392293a162",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-04-04T09:32:32+00:00",
        "end": "2011-04-04T15:44:09+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "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"
          } ]
        }
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-53b6-a81bb5c12f49"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3399-9492b5e87bc7"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-40db-6c50a97557ea"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-fea0-9d71acfc898c"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-de91-dc601099778d"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f75e-322f203b0a5a"
        }
      }, {
        "sequence": 6,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8bf2-3e20e8d513ae"
        }
      }, {
        "sequence": 7,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8175-95528254df00"
        }
      }, {
        "sequence": 8,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-883d-68892a85a23f"
        }
      }, {
        "sequence": 9,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-afe1-ad18bd383c99"
        }
      }, {
        "sequence": 10,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-2105-63b96e8cc781"
        }
      }, {
        "sequence": 11,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0f5d-8c83ecda7c4f"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ec93-fc8a72fce75a"
        } ]
      }, {
        "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,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 0.00,
          "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": "241046008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "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": "274788003"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 12,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 13,
        "informationLinkId": [ 5 ],
        "net": {
          "value": 0.00,
          "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": "81733005"
          } ]
        },
        "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": "3802001"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 16,
        "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": "64544008"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "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": "456191000124101"
          } ]
        },
        "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": "243085009"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 4830.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:3812448e-b69b-4fdd-f3be-6207abac1051",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "3812448e-b69b-4fdd-f3be-6207abac1051",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-c83c-c4392293a162"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-04-04T15:44:09+00:00",
        "end": "2012-04-04T15:44:09+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-53b6-a81bb5c12f49"
        },
        "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,
        "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": 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": "241046008"
          } ]
        },
        "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": 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": "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": 12,
        "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": 13,
        "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": 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": "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": 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": "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": 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": "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": 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": "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": 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": "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": 4830.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 3864.7599999999993,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6c28-775533e13765",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-6c28-775533e13765",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "50849002",
          "display": "Emergency room admission (procedure)"
        } ],
        "text": "Emergency room admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "2011-04-18T17:50:55+00:00",
        "end": "2011-04-19T07:50:55+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-478c-2aa0d5765716",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-478c-2aa0d5765716",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ],
        "text": "Overdose (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6c28-775533e13765"
      },
      "onsetDateTime": "2011-04-18T17:50:55+00:00",
      "abatementDateTime": "2011-04-19T07:50:55+00:00",
      "assertedDate": "2011-04-18T17:50:55+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-35df-bff799d0b385",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-35df-bff799d0b385",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-04-18T17:50:55+00:00",
        "end": "2011-04-19T07:50:55+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-478c-2aa0d5765716"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6c28-775533e13765"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:f0604d38-a304-9da7-6c5a-50598ecc4640",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "f0604d38-a304-9da7-6c5a-50598ecc4640",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-35df-bff799d0b385"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-04-19T07:50:55+00:00",
        "end": "2012-04-19T07:50:55+00:00"
      },
      "created": "2011-04-19T07:50:55+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-35df-bff799d0b385"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-478c-2aa0d5765716"
        },
        "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": "2011-04-18T17:50:55+00:00",
          "end": "2011-04-19T07:50:55+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6c28-775533e13765"
        } ],
        "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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": "2011-04-18T17:50:55+00:00",
          "end": "2011-04-19T07:50:55+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-cd6f-d7d83c573b11",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-cd6f-d7d83c573b11",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2011-05-03T07:50:55+00:00",
        "end": "2011-05-03T09:05:53+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ff95-f4b223d9ab67",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ff95-f4b223d9ab67",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-cd6f-d7d83c573b11"
      },
      "performedPeriod": {
        "start": "2011-05-03T07:50:55+00:00",
        "end": "2011-05-03T09:05:53+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0b3b-112b2860c60b",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-0b3b-112b2860c60b",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-05-03T07:50:55+00:00",
        "end": "2011-05-03T09:05:53+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ff95-f4b223d9ab67"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-cd6f-d7d83c573b11"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:372c9dcf-448f-373c-c67d-f4544215f913",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "372c9dcf-448f-373c-c67d-f4544215f913",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-0b3b-112b2860c60b"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-05-03T09:05:53+00:00",
        "end": "2012-05-03T09:05:53+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e7f7-8fea6272aa8e",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e7f7-8fea6272aa8e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2011-06-30T09:05:53+00:00",
        "end": "2011-06-30T10:21:06+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f623-bd6da003b49c",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-f623-bd6da003b49c",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e7f7-8fea6272aa8e"
      },
      "performedPeriod": {
        "start": "2011-06-30T09:05:53+00:00",
        "end": "2011-06-30T10:21:06+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3df7-770599baaa39",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-3df7-770599baaa39",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-06-30T09:05:53+00:00",
        "end": "2011-06-30T10:21:06+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f623-bd6da003b49c"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e7f7-8fea6272aa8e"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:9fb6058a-2149-b627-5fb1-b0763ec2ab46",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "9fb6058a-2149-b627-5fb1-b0763ec2ab46",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-3df7-770599baaa39"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-06-30T10:21:06+00:00",
        "end": "2012-06-30T10:21:06+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b547-8c175d442079",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-b547-8c175d442079",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2011-11-05T10:21:06+00:00",
        "end": "2011-11-05T11:48:44+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6dcd-f01b46e65930",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-6dcd-f01b46e65930",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-b547-8c175d442079"
      },
      "performedPeriod": {
        "start": "2011-11-05T10:21:06+00:00",
        "end": "2011-11-05T11:48:44+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1d94-8176c0859be5",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-1d94-8176c0859be5",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-11-05T10:21:06+00:00",
        "end": "2011-11-05T11:48:44+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6dcd-f01b46e65930"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-b547-8c175d442079"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:4c51de92-c384-168f-fb70-84fe35d65b12",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "4c51de92-c384-168f-fb70-84fe35d65b12",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-1d94-8176c0859be5"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-11-05T11:48:44+00:00",
        "end": "2012-11-05T11:48:44+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-58ec-f5bcd8e10baa",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-58ec-f5bcd8e10baa",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2011-12-05T11:48:44+00:00",
        "end": "2011-12-05T13:03:24+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5050-377e84e2c18e",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-5050-377e84e2c18e",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-58ec-f5bcd8e10baa"
      },
      "performedPeriod": {
        "start": "2011-12-05T11:48:44+00:00",
        "end": "2011-12-05T13:03:24+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5460-e7ec258333e2",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-5460-e7ec258333e2",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2011-12-05T11:48:44+00:00",
        "end": "2011-12-05T13:03:24+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5050-377e84e2c18e"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-58ec-f5bcd8e10baa"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:9d03c1bd-669c-ed92-7dcb-ec681712d167",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "9d03c1bd-669c-ed92-7dcb-ec681712d167",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-5460-e7ec258333e2"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2011-12-05T13:03:24+00:00",
        "end": "2012-12-05T13:03:24+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0363-370932f50d68",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-0363-370932f50d68",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "50849002",
          "display": "Emergency room admission (procedure)"
        } ],
        "text": "Emergency room admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "2012-02-01T13:03:24+00:00",
        "end": "2012-02-02T01:03:24+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-52bb-9f9519f65701",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-52bb-9f9519f65701",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ],
        "text": "Overdose (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0363-370932f50d68"
      },
      "onsetDateTime": "2012-02-01T13:03:24+00:00",
      "abatementDateTime": "2012-02-02T01:03:24+00:00",
      "assertedDate": "2012-02-01T13:03:24+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1423-933a05e3638c",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-1423-933a05e3638c",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-02-01T13:03:24+00:00",
        "end": "2012-02-02T01:03:24+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-52bb-9f9519f65701"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0363-370932f50d68"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:636ebcb9-a357-88a9-0433-96def5664524",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "636ebcb9-a357-88a9-0433-96def5664524",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-1423-933a05e3638c"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-02-02T01:03:24+00:00",
        "end": "2013-02-02T01:03:24+00:00"
      },
      "created": "2012-02-02T01:03:24+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1423-933a05e3638c"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-52bb-9f9519f65701"
        },
        "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": "2012-02-01T13:03:24+00:00",
          "end": "2012-02-02T01:03:24+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-0363-370932f50d68"
        } ],
        "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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": "2012-02-01T13:03:24+00:00",
          "end": "2012-02-02T01:03:24+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-7285-891c862577d5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2012-03-26T09:32:32+00:00",
        "end": "2012-03-26T10:22:01+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4b6a-a3eb7ca234a3",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4b6a-a3eb7ca234a3",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-58b4-02d45461bbe8",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-58b4-02d45461bbe8",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 3,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9ecc-67ec50fcf951",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9ecc-67ec50fcf951",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 71.700,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-bda2-dee59e767aa9",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-bda2-dee59e767aa9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 27.820,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b93a-0538d43ae236",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b93a-0538d43ae236",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 75,
          "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:7c50e28d-07cc-a4cf-9c6b-492e125e97b7",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9c6b-492e125e97b7",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 69,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d380-8795855ccdfa",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d380-8795855ccdfa",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 14,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0cbd-4f757a786537",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-0cbd-4f757a786537",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 5.1394,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-84f4-17e0e5250e25",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-84f4-17e0e5250e25",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 5.4006,
        "unit": "10*6/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*6/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f72d-cd1bdf762068",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-f72d-cd1bdf762068",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 16.050,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6bf4-6157fb72ee22",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6bf4-6157fb72ee22",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 41.661,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4253-cfc240eaa4a8",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4253-cfc240eaa4a8",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 90.132,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-89b9-cbc0f3d90477",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-89b9-cbc0f3d90477",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 30.123,
        "unit": "pg",
        "system": "http://unitsofmeasure.org",
        "code": "pg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b78a-a07f2b4a2468",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b78a-a07f2b4a2468",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 35.046,
        "unit": "g/dL",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-bba6-04a814dab423",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-bba6-04a814dab423",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 41.789,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-297e-e67060d571d1",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-297e-e67060d571d1",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 232.01,
        "unit": "10*3/uL",
        "system": "http://unitsofmeasure.org",
        "code": "10*3/uL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b415-73db45c5c715",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b415-73db45c5c715",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 12.021,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3a52-e3378b62c13c",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3a52-e3378b62c13c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 11.657,
        "unit": "fL",
        "system": "http://unitsofmeasure.org",
        "code": "fL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7b3a-bfed4b34d8b2",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-7b3a-bfed4b34d8b2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+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:7c50e28d-07cc-a4cf-c55e-f14c5dc982de",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-c55e-f14c5dc982de",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T10:22:01+00:00",
      "issued": "2012-03-26T10:22:01.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": "LA30124-4",
            "display": "Utilities"
          } ],
          "text": "Utilities"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-0faf-18869fff6459",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-0faf-18869fff6459",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T10:40:51+00:00",
      "issued": "2012-03-26T10:40:51.196+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-fdfd-07c6840c07a4",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-fdfd-07c6840c07a4",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T11:17:35+00:00",
      "issued": "2012-03-26T11:17:35.196+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d4a2-bbf82583e6b1",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-d4a2-bbf82583e6b1",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "430193006",
          "display": "Medication reconciliation (procedure)"
        } ],
        "text": "Medication reconciliation (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "performedPeriod": {
        "start": "2012-03-26T09:32:32+00:00",
        "end": "2012-03-26T09:47:32+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7360-744b794cda52",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-7360-744b794cda52",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "performedPeriod": {
        "start": "2012-03-26T09:32:32+00:00",
        "end": "2012-03-26T10:22:01+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3c3d-cf323e0faf18",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-3c3d-cf323e0faf18",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "performedPeriod": {
        "start": "2012-03-26T10:22:01+00:00",
        "end": "2012-03-26T10:40:51+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8db6-b815bceb9cc8",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-8db6-b815bceb9cc8",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "performedPeriod": {
        "start": "2012-03-26T10:40:51+00:00",
        "end": "2012-03-26T10:51:52+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-104b-f90b731f2ef9",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-104b-f90b731f2ef9",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "performedPeriod": {
        "start": "2012-03-26T10:51:52+00:00",
        "end": "2012-03-26T11:17:35+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5e9e-7fc56940805c",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-5e9e-7fc56940805c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "date": "2012-03-26T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-32de-7acbaf12801c",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-32de-7acbaf12801c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T09:32:32+00:00",
      "issued": "2012-03-26T09:32:32.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0cbd-4f757a786537",
        "display": "Leukocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-84f4-17e0e5250e25",
        "display": "Erythrocytes [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-f72d-cd1bdf762068",
        "display": "Hemoglobin [Mass/volume] in Blood"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6bf4-6157fb72ee22",
        "display": "Hematocrit [Volume Fraction] of Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4253-cfc240eaa4a8",
        "display": "MCV [Entitic mean volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-89b9-cbc0f3d90477",
        "display": "MCH [Entitic mass] by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-b78a-a07f2b4a2468",
        "display": "MCHC [Entitic Mass/volume] in Red Blood Cells by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-bba6-04a814dab423",
        "display": "Erythrocyte [DistWidth] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-297e-e67060d571d1",
        "display": "Platelets [#/volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-b415-73db45c5c715",
        "display": "Platelet distribution width [Entitic volume] in Blood by Automated count"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-3a52-e3378b62c13c",
        "display": "Platelet [Entitic mean volume] in Blood by Automated count"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9a13-b814b46eaf79",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-9a13-b814b46eaf79",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T10:40:51+00:00",
      "issued": "2012-03-26T10:40:51.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0faf-18869fff6459",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1a30-545541347500",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-1a30-545541347500",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
      },
      "effectiveDateTime": "2012-03-26T11:17:35+00:00",
      "issued": "2012-03-26T11:17:35.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-fdfd-07c6840c07a4",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-dc37-c6e4b101d2ef",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-dc37-c6e4b101d2ef",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-03-26T09:32:32+00:00",
        "end": "2012-03-26T10:22:01+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5e9e-7fc56940805c"
        }
      }, {
        "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"
          } ]
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d4a2-bbf82583e6b1"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7360-744b794cda52"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3c3d-cf323e0faf18"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8db6-b815bceb9cc8"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-104b-f90b731f2ef9"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7285-891c862577d5"
        } ]
      }, {
        "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": 849.84,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "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": 6,
        "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": 7,
        "informationLinkId": [ 3 ],
        "net": {
          "value": 74.58,
          "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": "171207006"
          } ]
        },
        "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": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 10,
        "informationLinkId": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 3071.98,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:79f95c7a-ce2a-d4d3-cc86-7641b9323310",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "79f95c7a-ce2a-d4d3-cc86-7641b9323310",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-dc37-c6e4b101d2ef"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2012-03-26T10:22:01+00:00",
        "end": "2013-03-26T10:22:01+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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": 169.96800000000002,
            "system": "urn: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": 679.8720000000001,
            "system": "urn: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": 849.84,
            "system": "urn: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": 849.84,
            "system": "urn: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"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 1628.62,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2457.5840000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-95da-c5910628f03d",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-95da-c5910628f03d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2012-11-12T08:32:32+00:00",
        "end": "2012-11-12T08:47:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "10509002",
          "display": "Acute bronchitis (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1417-42d5690ef8c0",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-1417-42d5690ef8c0",
      "clinicalStatus": "resolved",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "10509002",
          "display": "Acute bronchitis (disorder)"
        } ],
        "text": "Acute bronchitis (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-95da-c5910628f03d"
      },
      "onsetDateTime": "2012-11-12T08:32:32+00:00",
      "abatementDateTime": "2012-11-29T08:32:32+00:00",
      "assertedDate": "2012-11-12T08:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-bb17-dd0f66e30370",
    "resource": {
      "resourceType": "MedicationRequest",
      "id": "7c50e28d-07cc-a4cf-bb17-dd0f66e30370",
      "status": "completed",
      "intent": "order",
      "medicationCodeableConcept": {
        "coding": [ {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "1043400",
          "display": "Acetaminophen 21.7 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML / doxylamine succinate 0.417 MG/ML Oral Solution"
        } ],
        "text": "Acetaminophen 21.7 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML / doxylamine succinate 0.417 MG/ML Oral Solution"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-95da-c5910628f03d"
      },
      "authoredOn": "2012-11-12T08:32:32+00:00",
      "requester": {
        "agent": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        },
        "onBehalfOf": {
          "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
          "display": "TEWKSBURY HOSPITAL"
        }
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1417-42d5690ef8c0"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "MedicationRequest"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4710-07f74a58cddf",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-4710-07f74a58cddf",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-11-12T08:32:32+00:00",
        "end": "2012-11-12T08:47:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "prescription": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-bb17-dd0f66e30370"
      },
      "item": [ {
        "sequence": 1,
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-95da-c5910628f03d"
        } ]
      } ],
      "total": {
        "value": 173.62,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-cc3e-2b55f3efe136",
    "resource": {
      "resourceType": "CarePlan",
      "id": "7c50e28d-07cc-a4cf-cc3e-2b55f3efe136",
      "status": "completed",
      "intent": "order",
      "category": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "53950000",
          "display": "Respiratory therapy (procedure)"
        } ],
        "text": "Respiratory therapy (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-95da-c5910628f03d"
      },
      "period": {
        "start": "2012-11-12T08:32:32+00:00",
        "end": "2013-04-01T09:32:32+00:00"
      },
      "activity": [ {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "304510005",
              "display": "Recommendation to avoid exercise (procedure)"
            } ],
            "text": "Recommendation to avoid exercise (procedure)"
          },
          "status": "completed"
        }
      }, {
        "detail": {
          "code": {
            "coding": [ {
              "system": "http://snomed.info/sct",
              "code": "371605008",
              "display": "Deep breathing and coughing exercises (regime/therapy)"
            } ],
            "text": "Deep breathing and coughing exercises (regime/therapy)"
          },
          "status": "completed"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "CarePlan"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d757-689fc4306290",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-d757-689fc4306290",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-11-12T08:32:32+00:00",
        "end": "2012-11-12T08:47:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-1417-42d5690ef8c0"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-95da-c5910628f03d"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:5eafcbf8-a93a-036a-0a2a-c8b6e65aef32",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "5eafcbf8-a93a-036a-0a2a-c8b6e65aef32",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-d757-689fc4306290"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2012-11-12T08:47:32+00:00",
        "end": "2013-11-12T08:47:32+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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:7c50e28d-07cc-a4cf-1417-42d5690ef8c0"
        },
        "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:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-9240-ab5439ef7ce4",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999938498",
          "display": "Dr. Rema399 McDermott739"
        }
      } ],
      "period": {
        "start": "2012-11-19T09:32:32+00:00",
        "end": "2012-11-19T10:15:43+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
        "display": "URGENT HELP CHELMSFORD PC"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f5af-1c483c221096",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-f5af-1c483c221096",
      "clinicalStatus": "active",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "onsetDateTime": "2012-11-19T09:32:32+00:00",
      "assertedDate": "2012-11-19T09:32:32+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ccb5-fbb7404bb377",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-ccb5-fbb7404bb377",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1b63-7ef5e1ecaaea",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-1b63-7ef5e1ecaaea",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8d1f-44aa439325b5",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-8d1f-44aa439325b5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 72.900,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7413-4c9d9771cd80",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-7413-4c9d9771cd80",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 28.300,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3eb1-df13f3bb8ab1",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-3eb1-df13f3bb8ab1",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 76,
          "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": 117,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6d08-532613da761f",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6d08-532613da761f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 63,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4d88-47dd0b0cef70",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4d88-47dd0b0cef70",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 15,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a34e-a2e4b3825dcc",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-a34e-a2e4b3825dcc",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T09:32:32+00:00",
      "issued": "2012-11-19T09:32:32.196+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:7c50e28d-07cc-a4cf-7c65-1fae4fa686d1",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-7c65-1fae4fa686d1",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T10:15:43+00:00",
      "issued": "2012-11-19T10:15:43.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-65bc-92723c5ca0db",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-65bc-92723c5ca0db",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T10:52:00+00:00",
      "issued": "2012-11-19T10:52:00.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-059c-750cc4f15d2e",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-059c-750cc4f15d2e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "performedPeriod": {
        "start": "2012-11-19T09:32:32+00:00",
        "end": "2012-11-19T10:15:43+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-46a3-d8a3b3b2aa76",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-46a3-d8a3b3b2aa76",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "performedPeriod": {
        "start": "2012-11-19T10:15:43+00:00",
        "end": "2012-11-19T10:27:14+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c252-ec3218899d29",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-c252-ec3218899d29",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "performedPeriod": {
        "start": "2012-11-19T10:27:14+00:00",
        "end": "2012-11-19T10:52:00+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-652d-1893e100bc20",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-652d-1893e100bc20",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "date": "2012-11-19T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d94d-b94d6615299b",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-d94d-b94d6615299b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
      },
      "effectiveDateTime": "2012-11-19T10:52:00+00:00",
      "issued": "2012-11-19T10:52:00.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-65bc-92723c5ca0db",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1b49-03f7330f8331",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-1b49-03f7330f8331",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-11-19T09:32:32+00:00",
        "end": "2012-11-19T10:15:43+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|c05d73d0-b348-32ce-9fe5-13a720950f37",
        "display": "URGENT HELP CHELMSFORD PC"
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-652d-1893e100bc20"
        }
      }, {
        "sequence": 2,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-f5af-1c483c221096"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-059c-750cc4f15d2e"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-46a3-d8a3b3b2aa76"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-c252-ec3218899d29"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 142.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
        } ]
      }, {
        "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": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 5,
        "procedureLinkId": [ 2 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 6,
        "procedureLinkId": [ 3 ],
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 7,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 1647.36,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:2ceb3692-b2e9-54eb-6356-ab16620802fb",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "2ceb3692-b2e9-54eb-6356-ab16620802fb",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999938498"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999938498"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-1b49-03f7330f8331"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-11-19T10:15:43+00:00",
        "end": "2013-11-19T10:15:43+00:00"
      },
      "created": "2012-11-19T10:15:43+00:00",
      "provider": {
        "identifier": {
          "value": "9405d055-7cb4-3446-ba65-7361062fe5a6"
        }
      },
      "organization": {
        "identifier": {
          "value": "c05d73d0-b348-32ce-9fe5-13a720950f37"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1b49-03f7330f8331"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999938498"
          }
        },
        "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:7c50e28d-07cc-a4cf-f5af-1c483c221096"
        },
        "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": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+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:7c50e28d-07cc-a4cf-9240-ab5439ef7ce4"
        } ],
        "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": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "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"
            } ]
          }
        } ]
      }, {
        "sequence": 3,
        "diagnosisLinkId": [ 1 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        }
      }, {
        "sequence": 4,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "710824005"
          } ]
        },
        "servicedPeriod": {
          "start": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 5,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "servicedPeriod": {
          "start": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 6,
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "service": {
          "coding": [ {
            "system": "http://snomed.info/sct",
            "version": "v1",
            "code": "171207006"
          } ]
        },
        "servicedPeriod": {
          "start": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "net": {
          "value": 431.40,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      }, {
        "sequence": 7,
        "informationLinkId": [ 2 ],
        "category": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd",
            "code": "1",
            "display": "Medical care"
          } ]
        },
        "servicedPeriod": {
          "start": "2012-11-19T09:32:32+00:00",
          "end": "2012-11-19T10:15:43+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "20",
            "display": "Urgent Care Facility"
          } ]
        },
        "net": {
          "value": 74.58,
          "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": 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"
            } ]
          },
          "reason": {
            "coding": [ {
              "system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd",
              "code": "A",
              "display": "Allowed"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 709.98,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1317.8880000000001,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-312f-6e0e1687e727",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-312f-6e0e1687e727",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2012-11-26T09:32:32+00:00",
        "end": "2012-11-26T09:47:32+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-0126-ca6c355ebbd8",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-0126-ca6c355ebbd8",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-11-26T09:32:32+00:00",
        "end": "2012-11-26T09:47:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-312f-6e0e1687e727"
        } ]
      } ],
      "total": {
        "value": 85.55,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:0ddd9b31-5cea-7dbf-2f55-55f33479d4d9",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "0ddd9b31-5cea-7dbf-2f55-55f33479d4d9",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999994491"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-0126-ca6c355ebbd8"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2012-11-26T09:47:32+00:00",
        "end": "2013-11-26T09:47:32+00:00"
      },
      "created": "2012-11-26T09:47:32+00:00",
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0126-ca6c355ebbd8"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "2012-11-26T09:32:32+00:00",
          "end": "2012-11-26T09:47:32+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:7c50e28d-07cc-a4cf-312f-6e0e1687e727"
        } ],
        "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"
            } ]
          }
        } ]
      } ],
      "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:7c50e28d-07cc-a4cf-5da2-e99435296b1e",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-5da2-e99435296b1e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2013-04-01T09:32:32+00:00",
        "end": "2013-04-01T10:24:19+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4ec7-4947e81a210e",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-4ec7-4947e81a210e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "onsetDateTime": "2013-04-01T10:24:19+00:00",
      "assertedDate": "2013-04-01T10:24:19+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5fc6-430462920c0d",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-5fc6-430462920c0d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d741-e6bd1fcc220e",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d741-e6bd1fcc220e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 2,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-f102-249298483fdd",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-f102-249298483fdd",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 73.600,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2f36-755d996ea4c2",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-2f36-755d996ea4c2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 28.570,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-674a-f154ae2e43ed",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-674a-f154ae2e43ed",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 78,
          "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": 116,
          "unit": "mm[Hg]",
          "system": "http://unitsofmeasure.org",
          "code": "mm[Hg]"
        }
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-10b0-f472d7925be0",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-10b0-f472d7925be0",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 73,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b08c-24111c84bcdf",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-b08c-24111c84bcdf",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 16,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e30d-e8f7509840e6",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-e30d-e8f7509840e6",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 186.71,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-660d-fe872994f5c9",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-660d-fe872994f5c9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 109.85,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9227-5a3928d6c4e1",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9227-5a3928d6c4e1",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 113.99,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6e7d-0c671951d15e",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6e7d-0c671951d15e",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 50.740,
        "unit": "mg/dL",
        "system": "http://unitsofmeasure.org",
        "code": "mg/dL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d89d-644913de5387",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d89d-644913de5387",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+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:7c50e28d-07cc-a4cf-bd9f-90444ab40ac5",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-bd9f-90444ab40ac5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T10:24:19+00:00",
      "issued": "2013-04-01T10:24:19.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA27722-0",
            "display": "Less than once a week"
          } ],
          "text": "Less than once 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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": "LA30124-4",
            "display": "Utilities"
          } ],
          "text": "Utilities"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-4e18-146a83c6137c",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4e18-146a83c6137c",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T10:57:28+00:00",
      "issued": "2013-04-01T10:57:28.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-26bb-124113e281df",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-26bb-124113e281df",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "performedPeriod": {
        "start": "2013-04-01T09:32:32+00:00",
        "end": "2013-04-01T10:24:19+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a213-d1fdb120d677",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-a213-d1fdb120d677",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "performedPeriod": {
        "start": "2013-04-01T10:24:19+00:00",
        "end": "2013-04-01T10:34:49+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8556-a78271de7178",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-8556-a78271de7178",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "performedPeriod": {
        "start": "2013-04-01T10:34:49+00:00",
        "end": "2013-04-01T10:57:28+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a101-838965a5d0c5",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-a101-838965a5d0c5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T09:32:32+00:00",
      "issued": "2013-04-01T09:32:32.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e30d-e8f7509840e6",
        "display": "Cholesterol [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-660d-fe872994f5c9",
        "display": "Triglyceride [Mass/volume] in Serum or Plasma"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-9227-5a3928d6c4e1",
        "display": "Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay"
      }, {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6e7d-0c671951d15e",
        "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8fd7-5bd5cbc93d17",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-8fd7-5bd5cbc93d17",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
      },
      "effectiveDateTime": "2013-04-01T10:57:28+00:00",
      "issued": "2013-04-01T10:57:28.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-4e18-146a83c6137c",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-eee0-ad68c3d43e45",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-eee0-ad68c3d43e45",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2013-04-01T09:32:32+00:00",
        "end": "2013-04-01T10:24:19+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "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"
          } ]
        }
      } ],
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4ec7-4947e81a210e"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-26bb-124113e281df"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-a213-d1fdb120d677"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8556-a78271de7178"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5da2-e99435296b1e"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 74.58,
          "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": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 5,
        "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": 6,
        "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": 7,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 1580.16,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:6a24cac4-0f3d-168e-1943-7b8133748b12",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "6a24cac4-0f3d-168e-1943-7b8133748b12",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-eee0-ad68c3d43e45"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2013-04-01T10:24:19+00:00",
        "end": "2014-04-01T10:24:19+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-4ec7-4947e81a210e"
        },
        "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": 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": 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": "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": 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": "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": 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"
          } ]
        },
        "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"
            } ]
          }
        } ]
      } ],
      "totalCost": {
        "value": 642.78,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 1264.128,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7575-49b24ca740d0",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-7575-49b24ca740d0",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "56876005",
          "display": "Drug rehabilitation and detoxification (regime/therapy)"
        } ],
        "text": "Drug rehabilitation and detoxification (regime/therapy)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2013-09-26T01:03:24+00:00",
        "end": "2013-10-03T01:03:24+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5161-c60d8f3720c9",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-5161-c60d8f3720c9",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7575-49b24ca740d0"
      },
      "effectiveDateTime": "2013-09-26T01:03:24+00:00",
      "issued": "2013-09-26T01:03:24.196+00:00",
      "valueQuantity": {
        "value": 5,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b4fa-692bcd7dac72",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-b4fa-692bcd7dac72",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2013-09-26T01:03:24+00:00",
        "end": "2013-10-03T01:03:24+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7575-49b24ca740d0"
        } ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:95efbb0a-e214-9454-76e5-0345d3ffd954",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "95efbb0a-e214-9454-76e5-0345d3ffd954",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "extension": [ {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-ime-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-dsh-op-clm-val-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pass-thru-per-diem-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-clm-tot-pps-cptl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-ip-ddctbl-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-bene-pta-coinsrnc-lblty-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-ncvrd-chrg-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-ip-tot-ddctn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-dsprprtnt-shr-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-excptn-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-fsp-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-ime-amt-extension",
        "valueMoney": {
          "value": 400.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-cptl-outlier-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-clm-pps-old-cptl-hld-hrmls-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-nch-drg-outlier-aprvd-pmt-amt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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-inpatient-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-inpatient-prpayamt-extension",
        "valueMoney": {
          "value": 0.0,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-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": "7c50e28d-07cc-a4cf-b4fa-692bcd7dac72"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "extension": [ {
          "url": "https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-inpatient-claim-query-cd-extension",
          "valueCoding": {
            "system": "https://bluebutton.cms.gov/assets/ig/ValueSet-claim-query-cd",
            "code": "3",
            "display": "Final Bill"
          }
        } ],
        "start": "2013-10-03T01:03:24+00:00",
        "end": "2014-10-03T01:03:24+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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-inpatient-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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e2b6-1b737a5dc441",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-e2b6-1b737a5dc441",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2013-11-21T01:03:24+00:00",
        "end": "2013-11-21T02:10:18+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5fb0-93e96ea4910d",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-5fb0-93e96ea4910d",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-e2b6-1b737a5dc441"
      },
      "performedPeriod": {
        "start": "2013-11-21T01:03:24+00:00",
        "end": "2013-11-21T02:10:18+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-90ea-f27b6e2d7a36",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-90ea-f27b6e2d7a36",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2013-11-21T01:03:24+00:00",
        "end": "2013-11-21T02:10:18+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-5fb0-93e96ea4910d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-e2b6-1b737a5dc441"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:3f91d104-a813-6605-2368-7f10edfe167b",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "3f91d104-a813-6605-2368-7f10edfe167b",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-90ea-f27b6e2d7a36"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2013-11-21T02:10:18+00:00",
        "end": "2014-11-21T02:10:18+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8a45-277d9d706df3",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-8a45-277d9d706df3",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2013-12-21T02:10:18+00:00",
        "end": "2013-12-21T03:36:44+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-dfa0-e5dd45c44d2b",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-dfa0-e5dd45c44d2b",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-8a45-277d9d706df3"
      },
      "performedPeriod": {
        "start": "2013-12-21T02:10:18+00:00",
        "end": "2013-12-21T03:36:44+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ad94-32b1127fe762",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-ad94-32b1127fe762",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2013-12-21T02:10:18+00:00",
        "end": "2013-12-21T03:36:44+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-dfa0-e5dd45c44d2b"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8a45-277d9d706df3"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:9fb68ec9-d849-3020-fdf3-fae014b73b27",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "9fb68ec9-d849-3020-fdf3-fae014b73b27",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-ad94-32b1127fe762"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2013-12-21T03:36:44+00:00",
        "end": "2014-12-21T03:36:44+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-18c6-0dc59bf3e607",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-18c6-0dc59bf3e607",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2014-01-20T03:36:44+00:00",
        "end": "2014-01-20T04:59:08+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-36fd-c9c18f2adba0",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-36fd-c9c18f2adba0",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-18c6-0dc59bf3e607"
      },
      "performedPeriod": {
        "start": "2014-01-20T03:36:44+00:00",
        "end": "2014-01-20T04:59:08+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-31d0-27c91c042ded",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-31d0-27c91c042ded",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-01-20T03:36:44+00:00",
        "end": "2014-01-20T04:59:08+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-36fd-c9c18f2adba0"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-18c6-0dc59bf3e607"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:a612622b-cb68-79ae-acbe-7fa4c11da90f",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "a612622b-cb68-79ae-acbe-7fa4c11da90f",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-31d0-27c91c042ded"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-01-20T04:59:08+00:00",
        "end": "2015-01-20T04:59:08+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-db1b-db2b7c9d54f2",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-db1b-db2b7c9d54f2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2014-02-19T04:59:08+00:00",
        "end": "2014-02-19T06:20:08+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-743e-72fd59c436c7",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-743e-72fd59c436c7",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-db1b-db2b7c9d54f2"
      },
      "performedPeriod": {
        "start": "2014-02-19T04:59:08+00:00",
        "end": "2014-02-19T06:20:08+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-c646-6a76173512e6",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-c646-6a76173512e6",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-02-19T04:59:08+00:00",
        "end": "2014-02-19T06:20:08+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-743e-72fd59c436c7"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-db1b-db2b7c9d54f2"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:2ea04325-c012-6341-eb1b-20289977b54f",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "2ea04325-c012-6341-eb1b-20289977b54f",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Anthem"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-c646-6a76173512e6"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-02-19T06:20:08+00:00",
        "end": "2015-02-19T06:20:08+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6eab-aa2bac2174df",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-6eab-aa2bac2174df",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2014-03-21T06:20:08+00:00",
        "end": "2014-03-21T07:31:00+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4f6a-afd9e80c17bc",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-4f6a-afd9e80c17bc",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6eab-aa2bac2174df"
      },
      "performedPeriod": {
        "start": "2014-03-21T06:20:08+00:00",
        "end": "2014-03-21T07:31:00+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-b329-7fb4499013a4",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-b329-7fb4499013a4",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-03-21T06:20:08+00:00",
        "end": "2014-03-21T07:31:00+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-4f6a-afd9e80c17bc"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-6eab-aa2bac2174df"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:28854f74-8528-29ff-5f35-c5585c2399e8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "28854f74-8528-29ff-5f35-c5585c2399e8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Aetna"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-b329-7fb4499013a4"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-03-21T07:31:00+00:00",
        "end": "2015-03-21T07:31:00+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-00ef-76ee2e22597d",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2014-04-07T09:32:32+00:00",
        "end": "2014-04-07T10:14:14+00:00"
      },
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4487-e21f58176ab3",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-4487-e21f58176ab3",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "73438004",
          "display": "Unemployed (finding)"
        } ],
        "text": "Unemployed (finding)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "onsetDateTime": "2014-04-07T10:14:14+00:00",
      "assertedDate": "2014-04-07T10:14:14+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-fa81-7f1fb454e6b5",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-fa81-7f1fb454e6b5",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 160.5,
        "unit": "cm",
        "system": "http://unitsofmeasure.org",
        "code": "cm"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-4813-cd92ce97aa60",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-4813-cd92ce97aa60",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 1,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d5a4-794365acb893",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d5a4-794365acb893",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 75.5,
        "unit": "kg",
        "system": "http://unitsofmeasure.org",
        "code": "kg"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9e34-40a6e1f4e2bb",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-9e34-40a6e1f4e2bb",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 29.320,
        "unit": "kg/m2",
        "system": "http://unitsofmeasure.org",
        "code": "kg/m2"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-855b-20a52682188a",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-855b-20a52682188a",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "component": [ {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "8462-4",
            "display": "Diastolic Blood Pressure"
          } ],
          "text": "Diastolic Blood Pressure"
        },
        "valueQuantity": {
          "value": 89,
          "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:7c50e28d-07cc-a4cf-2b84-72b9c15f0606",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-2b84-72b9c15f0606",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 93,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-12de-bcea46a9bc0b",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-12de-bcea46a9bc0b",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+00:00",
      "valueQuantity": {
        "value": 12,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8138-663b61422744",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-8138-663b61422744",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T09:32:32+00:00",
      "issued": "2014-04-07T09:32:32.196+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:7c50e28d-07cc-a4cf-6f20-02d4258186dc",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6f20-02d4258186dc",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T10:14:14+00:00",
      "issued": "2014-04-07T10:14:14.196+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": "LA32-8",
            "display": "No"
          } ],
          "text": "No"
        }
      }, {
        "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": "LA27722-0",
            "display": "Less than once a week"
          } ],
          "text": "Less than once 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": "LA30133-5",
            "display": "Yes, it has kept me from medical appointments or from getting my medications"
          } ],
          "text": "Yes, it has kept me from medical appointments or from getting my medications"
        }
      }, {
        "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": 56556,
          "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": "LA6350-8",
            "display": "Private insurance"
          } ],
          "text": "Private insurance"
        }
      }, {
        "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": "LA30191-3",
            "display": "Less than high school degree"
          } ],
          "text": "Less than high school degree"
        }
      }, {
        "code": {
          "coding": [ {
            "system": "http://loinc.org",
            "code": "56799-0",
            "display": "Address"
          } ],
          "text": "Address"
        },
        "valueString": "741 Raynor Gate Suite 86"
      }, {
        "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": 8,
          "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": "LA43-5",
            "display": "English"
          } ],
          "text": "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": "LA46-8",
            "display": "Other"
          } ],
          "text": "Other"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-0712-7c10cb23a8b2",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-0712-7c10cb23a8b2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T10:36:38+00:00",
      "issued": "2014-04-07T10:36:38.196+00:00",
      "valueQuantity": {
        "value": 6,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d8d8-6a1cd6acf8f2",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-d8d8-6a1cd6acf8f2",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T11:14:04+00:00",
      "issued": "2014-04-07T11:14:04.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-12cb-bfebf70c96fe",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-12cb-bfebf70c96fe",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T11:57:51+00:00",
      "issued": "2014-04-07T11:57:51.196+00:00",
      "valueQuantity": {
        "value": 0,
        "unit": "{score}",
        "system": "http://unitsofmeasure.org",
        "code": "{score}"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-a4f1-4211e53c4dc8",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-a4f1-4211e53c4dc8",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "performedPeriod": {
        "start": "2014-04-07T09:32:32+00:00",
        "end": "2014-04-07T10:14:14+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-3560-5726c765dd13",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-3560-5726c765dd13",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "performedPeriod": {
        "start": "2014-04-07T10:14:14+00:00",
        "end": "2014-04-07T10:36:38+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ca5c-8252f480d6db",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ca5c-8252f480d6db",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "performedPeriod": {
        "start": "2014-04-07T10:36:38+00:00",
        "end": "2014-04-07T11:14:04+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-ae7d-08b0cff3c0d3",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-ae7d-08b0cff3c0d3",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "performedPeriod": {
        "start": "2014-04-07T11:14:04+00:00",
        "end": "2014-04-07T11:28:47+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-bf66-8acdae817c73",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-bf66-8acdae817c73",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "171207006",
          "display": "Depression screening (procedure)"
        } ],
        "text": "Depression screening (procedure)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "performedPeriod": {
        "start": "2014-04-07T11:28:47+00:00",
        "end": "2014-04-07T11:57:51+00:00"
      }
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-009a-71f0705c4888",
    "resource": {
      "resourceType": "Immunization",
      "id": "7c50e28d-07cc-a4cf-009a-71f0705c4888",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "encounter": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "date": "2014-04-07T09:32:32+00:00",
      "primarySource": true
    },
    "request": {
      "method": "POST",
      "url": "Immunization"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-81dd-e03e9250c6e3",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-81dd-e03e9250c6e3",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T10:36:38+00:00",
      "issued": "2014-04-07T10:36:38.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-0712-7c10cb23a8b2",
        "display": "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-14f5-0c7ed4b81027",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-14f5-0c7ed4b81027",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T11:14:04+00:00",
      "issued": "2014-04-07T11:14:04.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-d8d8-6a1cd6acf8f2",
        "display": "Total score [HARK]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-9b84-fa3750a88741",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-9b84-fa3750a88741",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
      },
      "effectiveDateTime": "2014-04-07T11:57:51+00:00",
      "issued": "2014-04-07T11:57:51.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-12cb-bfebf70c96fe",
        "display": "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e940-3231cb882141",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-e940-3231cb882141",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-04-07T09:32:32+00:00",
        "end": "2014-04-07T10:14:14+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        },
        "valueReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-009a-71f0705c4888"
        }
      }, {
        "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:7c50e28d-07cc-a4cf-4487-e21f58176ab3"
        }
      } ],
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-a4f1-4211e53c4dc8"
        }
      }, {
        "sequence": 2,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-3560-5726c765dd13"
        }
      }, {
        "sequence": 3,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ca5c-8252f480d6db"
        }
      }, {
        "sequence": 4,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-ae7d-08b0cff3c0d3"
        }
      }, {
        "sequence": 5,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-bf66-8acdae817c73"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-00ef-76ee2e22597d"
        } ]
      }, {
        "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": "710824005"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 4,
        "diagnosisLinkId": [ 1 ]
      }, {
        "sequence": 5,
        "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": 6,
        "informationLinkId": [ 2 ],
        "net": {
          "value": 74.58,
          "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": "866148006"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }, {
        "sequence": 8,
        "informationLinkId": [ 3 ],
        "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": [ 4 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 2653.54,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:b094998a-1644-2806-4e70-f53633bd1dc8",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "b094998a-1644-2806-4e70-f53633bd1dc8",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Aetna"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-e940-3231cb882141"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-04-07T10:14:14+00:00",
        "end": "2015-04-07T10:14:14+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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:7c50e28d-07cc-a4cf-4487-e21f58176ab3"
        },
        "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,
        "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": 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": "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": 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": "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": 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": 704.20,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 2122.8320000000003,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-d7aa-7759e5b0586f",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-d7aa-7759e5b0586f",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2014-07-27T07:31:00+00:00",
        "end": "2014-07-27T08:38:46+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-03b6-c251bb26f710",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-03b6-c251bb26f710",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-d7aa-7759e5b0586f"
      },
      "performedPeriod": {
        "start": "2014-07-27T07:31:00+00:00",
        "end": "2014-07-27T08:38:46+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-63c4-23ce63512836",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-63c4-23ce63512836",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-07-27T07:31:00+00:00",
        "end": "2014-07-27T08:38:46+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-03b6-c251bb26f710"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-d7aa-7759e5b0586f"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:f50729a9-67e4-faec-a159-3865e2ceb6a5",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "f50729a9-67e4-faec-a159-3865e2ceb6a5",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Aetna"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-63c4-23ce63512836"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-07-27T08:38:46+00:00",
        "end": "2015-07-27T08:38:46+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7545-2149f61b9833",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-7545-2149f61b9833",
      "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999994491",
          "display": "Dr. Alysha630 Koch169"
        }
      } ],
      "period": {
        "start": "2014-08-26T08:38:46+00:00",
        "end": "2014-08-26T09:52:59+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "6525002",
          "display": "Dependent drug abuse (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-418d-3bc57b9c3714",
    "resource": {
      "resourceType": "Procedure",
      "id": "7c50e28d-07cc-a4cf-418d-3bc57b9c3714",
      "status": "completed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "52052004",
          "display": "Rehabilitation therapy (regime/therapy)"
        } ],
        "text": "Rehabilitation therapy (regime/therapy)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-7545-2149f61b9833"
      },
      "performedPeriod": {
        "start": "2014-08-26T08:38:46+00:00",
        "end": "2014-08-26T09:52:59+00:00"
      },
      "reasonReference": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5581-dc9fcba63636",
        "display": "Dependent drug abuse (disorder)"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "Procedure"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-7f78-85ae9de4b944",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-7f78-85ae9de4b944",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-08-26T08:38:46+00:00",
        "end": "2014-08-26T09:52:59+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4",
        "display": "TEWKSBURY HOSPITAL"
      },
      "procedure": [ {
        "sequence": 1,
        "procedureReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-418d-3bc57b9c3714"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 85.55,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-7545-2149f61b9833"
        } ]
      }, {
        "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": "52052004"
          } ]
        },
        "net": {
          "value": 431.40,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:672c48fe-55ce-65b1-17a2-2cd5b703c56e",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "672c48fe-55ce-65b1-17a2-2cd5b703c56e",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Aetna"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-7f78-85ae9de4b944"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-08-26T09:52:59+00:00",
        "end": "2015-08-26T09:52:59+00:00"
      },
      "provider": {
        "identifier": {
          "value": "3e979fd9-4b62-3544-9ba8-5ed03b508c7b"
        }
      },
      "organization": {
        "identifier": {
          "value": "2836d9ac-c6a6-39d1-8f13-fdf0fc8928f4"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999994491"
          }
        },
        "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": "52052004"
          } ]
        },
        "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": 516.95,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 413.56,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-1053-59597b0303e6",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-1053-59597b0303e6",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EMER"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "50849002",
          "display": "Emergency room admission (procedure)"
        } ],
        "text": "Emergency room admission (procedure)"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981696",
          "display": "Dr. Pearlene638 Towne435"
        }
      } ],
      "period": {
        "start": "2014-10-23T09:52:59+00:00",
        "end": "2014-10-23T10:52:59+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-8604-a10dc407c12d",
    "resource": {
      "resourceType": "Condition",
      "id": "7c50e28d-07cc-a4cf-8604-a10dc407c12d",
      "clinicalStatus": "active",
      "verificationStatus": "confirmed",
      "code": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ],
        "text": "Overdose (disorder)"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-1053-59597b0303e6"
      },
      "onsetDateTime": "2014-10-23T09:52:59+00:00",
      "assertedDate": "2014-10-23T09:52:59+00:00"
    },
    "request": {
      "method": "POST",
      "url": "Condition"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-5eb4-0bfb442c3175",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-5eb4-0bfb442c3175",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-10-23T09:52:59+00:00",
        "end": "2014-10-23T10:52:59+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|a2f8d8fe-665e-390f-8b9b-efdc0b14a77c",
        "display": "LOWELL COMMUNITY HEALTH CENTER"
      },
      "diagnosis": [ {
        "sequence": 1,
        "diagnosisReference": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-8604-a10dc407c12d"
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-1053-59597b0303e6"
        } ]
      }, {
        "sequence": 2,
        "diagnosisLinkId": [ 1 ]
      } ],
      "total": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:103a88f8-cb36-c222-9702-c3eab6fa0c1e",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "103a88f8-cb36-c222-9702-c3eab6fa0c1e",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Aetna"
        }
      }, {
        "resourceType": "ReferralRequest",
        "id": "referral",
        "status": "completed",
        "intent": "order",
        "subject": {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
        },
        "requester": {
          "agent": {
            "identifier": {
              "system": "http://hl7.org/fhir/sid/us-npi",
              "value": "9999981696"
            }
          }
        },
        "recipient": [ {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        } ]
      } ],
      "identifier": [ {
        "system": "https://bluebutton.cms.gov/resources/variables/clm_id",
        "value": "7c50e28d-07cc-a4cf-5eb4-0bfb442c3175"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-10-23T10:52:59+00:00",
        "end": "2015-10-23T10:52:59+00:00"
      },
      "created": "2014-10-23T10:52:59+00:00",
      "provider": {
        "identifier": {
          "value": "0b717c7b-2230-3002-bd21-6d833aa4a2d8"
        }
      },
      "organization": {
        "identifier": {
          "value": "a2f8d8fe-665e-390f-8b9b-efdc0b14a77c"
        }
      },
      "referral": {
        "reference": "#referral"
      },
      "claim": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-5eb4-0bfb442c3175"
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981696"
          }
        },
        "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:7c50e28d-07cc-a4cf-8604-a10dc407c12d"
        },
        "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": "2014-10-23T09:52:59+00:00",
          "end": "2014-10-23T10:52:59+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        },
        "net": {
          "value": 146.18,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-1053-59597b0303e6"
        } ],
        "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": 29.236000000000004,
            "system": "urn: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": 116.94400000000002,
            "system": "urn: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": 146.18,
            "system": "urn: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": 146.18,
            "system": "urn: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": "2014-10-23T09:52:59+00:00",
          "end": "2014-10-23T10:52:59+00:00"
        },
        "locationCodeableConcept": {
          "coding": [ {
            "system": "https://bluebutton.cms.gov/resources/variables/line_place_of_srvc_cd",
            "code": "23",
            "display": "Emergency Room"
          } ]
        }
      } ],
      "totalCost": {
        "value": 146.18,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 116.94400000000002,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-33a5-d3f03ffc9b31",
    "resource": {
      "resourceType": "Encounter",
      "id": "7c50e28d-07cc-a4cf-33a5-d3f03ffc9b31",
      "status": "finished",
      "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB"
      },
      "type": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "308646001",
          "display": "Death Certification"
        } ],
        "text": "Death Certification"
      } ],
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "participant": [ {
        "individual": {
          "reference": "Practitioner?identifier=http://hl7.org/fhir/sid/us-npi|9999981597",
          "display": "Dr. Regena252 Huel628"
        }
      } ],
      "period": {
        "start": "2014-11-03T09:32:32+00:00",
        "end": "2014-11-03T09:47:32+00:00"
      },
      "reason": [ {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ]
      } ],
      "serviceProvider": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      }
    },
    "request": {
      "method": "POST",
      "url": "Encounter"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-6c5a-bb77b5c8b7e6",
    "resource": {
      "resourceType": "Observation",
      "id": "7c50e28d-07cc-a4cf-6c5a-bb77b5c8b7e6",
      "status": "final",
      "category": [ {
        "coding": [ {
          "system": "http://hl7.org/fhir/observation-category",
          "code": "exam",
          "display": "exam"
        } ]
      } ],
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69453-9",
          "display": "Cause of Death [US Standard Certificate of Death]"
        } ],
        "text": "Cause of Death [US Standard Certificate of Death]"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-33a5-d3f03ffc9b31"
      },
      "effectiveDateTime": "2014-11-03T09:32:32+00:00",
      "issued": "2014-11-03T09:32:32.196+00:00",
      "valueCodeableConcept": {
        "coding": [ {
          "system": "http://snomed.info/sct",
          "code": "1149222004",
          "display": "Overdose (disorder)"
        } ],
        "text": "Overdose (disorder)"
      }
    },
    "request": {
      "method": "POST",
      "url": "Observation"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-e6a7-c59ec0d15128",
    "resource": {
      "resourceType": "DiagnosticReport",
      "id": "7c50e28d-07cc-a4cf-e6a7-c59ec0d15128",
      "status": "final",
      "code": {
        "coding": [ {
          "system": "http://loinc.org",
          "code": "69409-1",
          "display": "U.S. standard certificate of death - 2003 revision"
        } ],
        "text": "U.S. standard certificate of death - 2003 revision"
      },
      "subject": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "context": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-33a5-d3f03ffc9b31"
      },
      "effectiveDateTime": "2014-11-03T09:32:32+00:00",
      "issued": "2014-11-03T09:32:32.196+00:00",
      "result": [ {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-6c5a-bb77b5c8b7e6",
        "display": "Cause of Death [US Standard Certificate of Death]"
      } ]
    },
    "request": {
      "method": "POST",
      "url": "DiagnosticReport"
    }
  }, {
    "fullUrl": "urn:uuid:7c50e28d-07cc-a4cf-2167-dbb9a2794fd1",
    "resource": {
      "resourceType": "Claim",
      "id": "7c50e28d-07cc-a4cf-2167-dbb9a2794fd1",
      "status": "active",
      "use": "complete",
      "patient": {
        "reference": "urn:uuid:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "billablePeriod": {
        "start": "2014-11-03T09:32:32+00:00",
        "end": "2014-11-03T09:47:32+00:00"
      },
      "organization": {
        "reference": "Organization?identifier=https://github.com/synthetichealth/synthea|ee6705d5-db4a-3120-bbe1-1e72972a841f",
        "display": "LOWELL COMMUNITY HEALTH CENTER, INC."
      },
      "information": [ {
        "sequence": 1,
        "category": {
          "coding": [ {
            "system": "http://hl7.org/fhir/claiminformationcategory",
            "code": "info"
          } ]
        }
      } ],
      "item": [ {
        "sequence": 1,
        "net": {
          "value": 136.80,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        },
        "encounter": [ {
          "reference": "urn:uuid:7c50e28d-07cc-a4cf-33a5-d3f03ffc9b31"
        } ]
      }, {
        "sequence": 2,
        "informationLinkId": [ 1 ],
        "net": {
          "value": 74.58,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      } ],
      "total": {
        "value": 211.38,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      }
    },
    "request": {
      "method": "POST",
      "url": "Claim"
    }
  }, {
    "fullUrl": "urn:uuid:ed8aa1c3-0845-316a-a256-af951701ac5c",
    "resource": {
      "resourceType": "ExplanationOfBenefit",
      "id": "ed8aa1c3-0845-316a-a256-af951701ac5c",
      "contained": [ {
        "resourceType": "Coverage",
        "id": "coverage",
        "type": {
          "text": "Aetna"
        }
      } ],
      "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": "7c50e28d-07cc-a4cf-2167-dbb9a2794fd1"
      }, {
        "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:7c50e28d-07cc-a4cf-eb58-b2a15bc552a3"
      },
      "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": "2014-11-03T09:47:32+00:00",
        "end": "2015-11-03T09:47:32+00:00"
      },
      "provider": {
        "identifier": {
          "value": "a6e9fa30-0904-3730-9451-afe0a71dfab0"
        }
      },
      "organization": {
        "identifier": {
          "value": "ee6705d5-db4a-3120-bbe1-1e72972a841f"
        }
      },
      "careTeam": [ {
        "sequence": 1,
        "provider": {
          "identifier": {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9999981597"
          }
        },
        "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": 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": 211.38,
        "system": "urn:iso:std:iso:4217",
        "code": "USD"
      },
      "payment": {
        "amount": {
          "value": 169.104,
          "system": "urn:iso:std:iso:4217",
          "code": "USD"
        }
      }
    },
    "request": {
      "method": "POST",
      "url": "ExplanationOfBenefit"
    }
  } ]
}
