<custodian> <reference value="Organization/5d3f4ac0-2b44-4d48-b363-e63efa72973b"/> </custodian> <section> <code> <coding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Section_Type"/> <code value="Prescription"/> </coding> </code> <entry> <reference value="MedicationRequest/4739972b-52d6-4bea-9ba1-d360f8c22689"/> </entry> </section> <section> <code> <coding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Section_Type"/> <code value="Coverage"/> </coding> </code> <entry> <reference value="Coverage/e51239e1-ba74-48e0-97fb-9754d2b05c60"/> </entry> </section> </Composition> </resource> </entry> <entry> <fullUrl value="http://pvs.praxis.local/fhir/MedicationRequest/4739972b-52d6-4bea-9ba1-d360f8c22689"/> <resource> <MedicationRequest> <id value="4739972b-52d6-4bea-9ba1-d360f8c22689"/> <meta> <versionId value="1"/> <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Prescription|1.4"/> </meta> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_StatusCoPayment"> <valueCoding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_StatusCoPayment"/> <code value="1"/> </valueCoding> </extension> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_EmergencyServicesFee"> <valueBoolean value="false"/> </extension> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_SER"> <valueBoolean value="false"/> </extension> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Multiple_Prescription"> <extension url="Kennzeichen"> <valueBoolean value="false"/> </extension> </extension> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_DosageFlag"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction"> <valueMarkdown value="1–3mal/Tag auf die erkrankten Hautstellen auftragen"/> </extension> <extension url="http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta"> <extension url="algorithmVersion"> <valueString value="1.0.0"/> </extension> <extension url="language"> <valueCode value="de-DE"/> </extension> </extension> <status value="active"/> <intent value="order"/> <medicationReference> <reference value="Medication/5cd916fc-2ae2-4148-b016-911ec5f4c0a5"/> </medicationReference> <subject> <reference value="Patient/30635f5d-c233-4500-94e8-6414940236aa"/> </subject> <authoredOn value="2025-05-20"/> <requester> <reference value="Practitioner/ec5b4fcf-9739-4055-b23c-a5b3a65beb66"/> </requester> <insurance> <reference value="Coverage/e51239e1-ba74-48e0-97fb-9754d2b05c60"/> </insurance> <dosageInstruction> <text value="1–3mal/Tag auf die erkrankten Hautstellen auftragen"/> </dosageInstruction> <dispenseRequest> <quantity> <value value="1"/> <unit value="Packung"/> </quantity> </dispenseRequest> <substitution> <allowedBoolean value="true"/> </substitution> </MedicationRequest> </resource> </entry> <entry> <fullUrl value="http://pvs.praxis.local/fhir/Medication/5cd916fc-2ae2-4148-b016-911ec5f4c0a5"/> <resource> <Medication> <id value="5cd916fc-2ae2-4148-b016-911ec5f4c0a5"/> <meta> <versionId value="1"/> <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Compounding|1.4"/> </meta> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Medication_Type"> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <version value="http://snomed.info/sct/11000274103/version/20240515"/> <code value="1208954007"/> <display value="Extemporaneous preparation (product)"/> </coding> </valueCodeableConcept> </extension> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_Category"> <valueCoding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Medication_Category"/> <code value="00"/> </valueCoding> </extension> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_Vaccine"> <valueBoolean value="false"/> </extension> <code> <coding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Medication_Type"/> <code value="rezeptur"/> </coding> </code> <form> <text value="Lösung"/> </form> <amount> <numerator> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_PackagingSize"> <valueString value="100"/> </extension> <unit value="ml"/> </numerator> <denominator> <value value="1"/> </denominator> </amount> <ingredient> <itemCodeableConcept> <text value="Salicylsäure"/> </itemCodeableConcept> <strength> <numerator> <value value="5"/> <unit value="g"/> </numerator> <denominator> <value value="1"/> </denominator> </strength> </ingredient> <ingredient> <itemCodeableConcept> <text value="2-propanol 70 %"/> </itemCodeableConcept> <strength> <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_Ingredient_Amount"> <valueString value="Ad 100 g"/> </extension> </strength> </ingredient> </Medication> </resource> </entry> <entry> <fullUrl value="http://pvs.praxis.local/fhir/Patient/30635f5d-c233-4500-94e8-6414940236aa"/> <resource> <Patient> <id value="30635f5d-c233-4500-94e8-6414940236aa"/> <meta> <versionId value="1"/> <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Patient|1.3"/> </meta> <identifier> <type> <coding> <system value="http://fhir.de/CodeSystem/identifier-type-de-basis"/> <code value="KVZ10"/> </coding> </type> <system value="http://fhir.de/sid/gkv/kvid-10"/> <value value="K220645122"/> </identifier> <name> <use value="official"/> <family value="Schuhmann"> <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name"> <valueString value="Schuhmann"/> </extension> </family> <given value="Sahra"/> </name> <birthDate value="1970-12-24"/> <address> <type value="both"/> <line value="Berliner Straße 1"> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber"> <valueString value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName"> <valueString value="Berliner Straße"/> </extension> </line> <city value="Husum"/> <postalCode value="25813"/> <country value="D"/> </address> </Patient> </resource> </entry> <entry> <fullUrl value="http://pvs.praxis.local/fhir/Practitioner/ec5b4fcf-9739-4055-b23c-a5b3a65beb66"/> <resource> <Practitioner> <id value="ec5b4fcf-9739-4055-b23c-a5b3a65beb66"/> <meta> <versionId value="1"/> <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Practitioner|1.3"/> </meta> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="LANR"/> </coding> </type> <system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_ANR"/> <value value="123412821"/> </identifier> <name> <use value="official"/> <family value="Schmidt"> <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name"> <valueString value="Schmidt"/> </extension> </family> <given value="Hanna"/> <prefix value="Dr."> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier"> <valueCode value="AC"/> </extension> </prefix> </name> <qualification> <code> <coding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_Qualification_Type"/> <code value="00"/> </coding> </code> </qualification> <qualification> <code> <coding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_Berufsbezeichnung"/> <code value="Berufsbezeichnung"/> </coding> <text value="Dermatologin"/> </code> </qualification> </Practitioner> </resource> </entry> <entry> <fullUrl value="http://pvs.praxis.local/fhir/Organization/5d3f4ac0-2b44-4d48-b363-e63efa72973b"/> <resource> <Organization> <id value="5d3f4ac0-2b44-4d48-b363-e63efa72973b"/> <meta> <versionId value="1"/> <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Organization|1.3"/> </meta> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="BSNR"/> </coding> </type> <system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_BSNR"/> <value value="721111100"/> </identifier> <name value="MVZ"/> <telecom> <system value="phone"/> <value value="0301234567"/> </telecom> <telecom> <system value="fax"/> <value value="030123456789"/> </telecom> <telecom> <system value="email"/> <value value="mvz@e-mail.de"/> </telecom> <address> <type value="both"/> <line value="Herbert-Lewin-Platz 2"> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber"> <valueString value="2"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName"> <valueString value="Herbert-Lewin-Platz"/> </extension> </line> <city value="Berlin"/> <postalCode value="10623"/> <country value="D"/> </address> </Organization> </resource> </entry> <entry> <fullUrl value="http://pvs.praxis.local/fhir/Coverage/e51239e1-ba74-48e0-97fb-9754d2b05c60"/> <resource> <Coverage> <id value="e51239e1-ba74-48e0-97fb-9754d2b05c60"/> <meta> <versionId value="1"/> <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Coverage|1.3"/> </meta> <extension url="http://fhir.de/StructureDefinition/gkv/besondere-personengruppe"> <valueCoding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PERSONENGRUPPE"/> <code value="00"/> </valueCoding> </extension> <extension url="http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen"> <valueCoding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DMP"/> <code value="00"/> </valueCoding> </extension> <extension url="http://fhir.de/StructureDefinition/gkv/wop"> <valueCoding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_ITA_WOP"/> <code value="01"/> </valueCoding> </extension> <extension url="http://fhir.de/StructureDefinition/gkv/versichertenart"> <valueCoding> <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_VERSICHERTENSTATUS"/> <code value="1"/> </valueCoding> </extension> <status value="active"/> <type> <coding> <system value="http://fhir.de/CodeSystem/versicherungsart-de-basis"/> <code value="GKV"/> </coding> </type> <beneficiary> <reference value="Patient/30635f5d-c233-4500-94e8-6414940236aa"/> </beneficiary> <payor> <identifier> <system value="http://fhir.de/sid/arge-ik/iknr"/> <value value="108018347"/> </identifier> <display value="AOK Baden-Württemberg"/> </payor> </Coverage> </resource> </entry> </Bundle>


        
        
          
            
            
          
        
        
          
        
        
        
          
          
        
        
          
          
            
            
          
        
        
        <custodian>
          <reference value="Organization/5d3f4ac0-2b44-4d48-b363-e63efa72973b"/>
        </custodian>
        <section>
          <code>
            <coding>
              <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Section_Type"/>
              <code value="Prescription"/>
            </coding>
          </code>
          <entry>
            <reference value="MedicationRequest/4739972b-52d6-4bea-9ba1-d360f8c22689"/>
          </entry>
        </section>
        <section>
          <code>
            <coding>
              <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Section_Type"/>
              <code value="Coverage"/>
            </coding>
          </code>
          <entry>
            <reference value="Coverage/e51239e1-ba74-48e0-97fb-9754d2b05c60"/>
          </entry>
        </section>
      </Composition>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://pvs.praxis.local/fhir/MedicationRequest/4739972b-52d6-4bea-9ba1-d360f8c22689"/>
    <resource>
      <MedicationRequest>
        <id value="4739972b-52d6-4bea-9ba1-d360f8c22689"/>
        <meta>
          <versionId value="1"/>
          <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Prescription|1.4"/>
        </meta>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_StatusCoPayment">
          <valueCoding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_StatusCoPayment"/>
            <code value="1"/>
          </valueCoding>
        </extension>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_EmergencyServicesFee">
          <valueBoolean value="false"/>
        </extension>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_SER">
          <valueBoolean value="false"/>
        </extension>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Multiple_Prescription">
          <extension url="Kennzeichen">
            <valueBoolean value="false"/>
          </extension>
        </extension>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_DosageFlag">
          <valueBoolean value="true"/>
        </extension>
        <extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction">
          <valueMarkdown value="1–3mal/Tag auf die erkrankten Hautstellen auftragen"/>
        </extension>
        <extension url="http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta">
          <extension url="algorithmVersion">
            <valueString value="1.0.0"/>
          </extension>
          <extension url="language">
            <valueCode value="de-DE"/>
          </extension>
        </extension>
        <status value="active"/>
        <intent value="order"/>
        <medicationReference>
          <reference value="Medication/5cd916fc-2ae2-4148-b016-911ec5f4c0a5"/>
        </medicationReference>
        <subject>
          <reference value="Patient/30635f5d-c233-4500-94e8-6414940236aa"/>
        </subject>
        <authoredOn value="2025-05-20"/>
        <requester>
          <reference value="Practitioner/ec5b4fcf-9739-4055-b23c-a5b3a65beb66"/>
        </requester>
        <insurance>
          <reference value="Coverage/e51239e1-ba74-48e0-97fb-9754d2b05c60"/>
        </insurance>
        <dosageInstruction>
          <text value="1–3mal/Tag auf die erkrankten Hautstellen auftragen"/>
        </dosageInstruction>
        <dispenseRequest>
          <quantity>
            <value value="1"/>
            <unit value="Packung"/>
          </quantity>
        </dispenseRequest>
        <substitution>
          <allowedBoolean value="true"/>
        </substitution>
      </MedicationRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://pvs.praxis.local/fhir/Medication/5cd916fc-2ae2-4148-b016-911ec5f4c0a5"/>
    <resource>
      <Medication>
        <id value="5cd916fc-2ae2-4148-b016-911ec5f4c0a5"/>
        <meta>
          <versionId value="1"/>
          <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Compounding|1.4"/>
        </meta>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Medication_Type">
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <version value="http://snomed.info/sct/11000274103/version/20240515"/>
              <code value="1208954007"/>
              <display value="Extemporaneous preparation (product)"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_Category">
          <valueCoding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Medication_Category"/>
            <code value="00"/>
          </valueCoding>
        </extension>
        <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_Vaccine">
          <valueBoolean value="false"/>
        </extension>
        <code>
          <coding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_ERP_Medication_Type"/>
            <code value="rezeptur"/>
          </coding>
        </code>
        <form>
          <text value="Lösung"/>
        </form>
        <amount>
          <numerator>
            <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_PackagingSize">
              <valueString value="100"/>
            </extension>
            <unit value="ml"/>
          </numerator>
          <denominator>
            <value value="1"/>
          </denominator>
        </amount>
        <ingredient>
          <itemCodeableConcept>
            <text value="Salicylsäure"/>
          </itemCodeableConcept>
          <strength>
            <numerator>
              <value value="5"/>
              <unit value="g"/>
            </numerator>
            <denominator>
              <value value="1"/>
            </denominator>
          </strength>
        </ingredient>
        <ingredient>
          <itemCodeableConcept>
            <text value="2-propanol 70 %"/>
          </itemCodeableConcept>
          <strength>
            <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Medication_Ingredient_Amount">
              <valueString value="Ad 100 g"/>
            </extension>
          </strength>
        </ingredient>
      </Medication>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://pvs.praxis.local/fhir/Patient/30635f5d-c233-4500-94e8-6414940236aa"/>
    <resource>
      <Patient>
        <id value="30635f5d-c233-4500-94e8-6414940236aa"/>
        <meta>
          <versionId value="1"/>
          <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Patient|1.3"/>
        </meta>
        <identifier>
          <type>
            <coding>
              <system value="http://fhir.de/CodeSystem/identifier-type-de-basis"/>
              <code value="KVZ10"/>
            </coding>
          </type>
          <system value="http://fhir.de/sid/gkv/kvid-10"/>
          <value value="K220645122"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="Schuhmann">
            <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
              <valueString value="Schuhmann"/>
            </extension>
          </family>
          <given value="Sahra"/>
        </name>
        <birthDate value="1970-12-24"/>
        <address>
          <type value="both"/>
          <line value="Berliner Straße 1">
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
              <valueString value="1"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
              <valueString value="Berliner Straße"/>
            </extension>
          </line>
          <city value="Husum"/>
          <postalCode value="25813"/>
          <country value="D"/>
        </address>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://pvs.praxis.local/fhir/Practitioner/ec5b4fcf-9739-4055-b23c-a5b3a65beb66"/>
    <resource>
      <Practitioner>
        <id value="ec5b4fcf-9739-4055-b23c-a5b3a65beb66"/>
        <meta>
          <versionId value="1"/>
          <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Practitioner|1.3"/>
        </meta>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="LANR"/>
            </coding>
          </type>
          <system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_ANR"/>
          <value value="123412821"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="Schmidt">
            <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
              <valueString value="Schmidt"/>
            </extension>
          </family>
          <given value="Hanna"/>
          <prefix value="Dr.">
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier">
              <valueCode value="AC"/>
            </extension>
          </prefix>
        </name>
        <qualification>
          <code>
            <coding>
              <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_Qualification_Type"/>
              <code value="00"/>
            </coding>
          </code>
        </qualification>
        <qualification>
          <code>
            <coding>
              <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_FOR_Berufsbezeichnung"/>
              <code value="Berufsbezeichnung"/>
            </coding>
            <text value="Dermatologin"/>
          </code>
        </qualification>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://pvs.praxis.local/fhir/Organization/5d3f4ac0-2b44-4d48-b363-e63efa72973b"/>
    <resource>
      <Organization>
        <id value="5d3f4ac0-2b44-4d48-b363-e63efa72973b"/>
        <meta>
          <versionId value="1"/>
          <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Organization|1.3"/>
        </meta>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="BSNR"/>
            </coding>
          </type>
          <system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_BSNR"/>
          <value value="721111100"/>
        </identifier>
        <name value="MVZ"/>
        <telecom>
          <system value="phone"/>
          <value value="0301234567"/>
        </telecom>
        <telecom>
          <system value="fax"/>
          <value value="030123456789"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="mvz@e-mail.de"/>
        </telecom>
        <address>
          <type value="both"/>
          <line value="Herbert-Lewin-Platz 2">
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
              <valueString value="2"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
              <valueString value="Herbert-Lewin-Platz"/>
            </extension>
          </line>
          <city value="Berlin"/>
          <postalCode value="10623"/>
          <country value="D"/>
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://pvs.praxis.local/fhir/Coverage/e51239e1-ba74-48e0-97fb-9754d2b05c60"/>
    <resource>
      <Coverage>
        <id value="e51239e1-ba74-48e0-97fb-9754d2b05c60"/>
        <meta>
          <versionId value="1"/>
          <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Coverage|1.3"/>
        </meta>
        <extension url="http://fhir.de/StructureDefinition/gkv/besondere-personengruppe">
          <valueCoding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PERSONENGRUPPE"/>
            <code value="00"/>
          </valueCoding>
        </extension>
        <extension url="http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen">
          <valueCoding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DMP"/>
            <code value="00"/>
          </valueCoding>
        </extension>
        <extension url="http://fhir.de/StructureDefinition/gkv/wop">
          <valueCoding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_ITA_WOP"/>
            <code value="01"/>
          </valueCoding>
        </extension>
        <extension url="http://fhir.de/StructureDefinition/gkv/versichertenart">
          <valueCoding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_VERSICHERTENSTATUS"/>
            <code value="1"/>
          </valueCoding>
        </extension>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://fhir.de/CodeSystem/versicherungsart-de-basis"/>
            <code value="GKV"/>
          </coding>
        </type>
        <beneficiary>
          <reference value="Patient/30635f5d-c233-4500-94e8-6414940236aa"/>
        </beneficiary>
        <payor>
          <identifier>
            <system value="http://fhir.de/sid/arge-ik/iknr"/>
            <value value="108018347"/>
          </identifier>
          <display value="AOK Baden-Württemberg"/>
        </payor>
      </Coverage>
    </resource>
  </entry>
</Bundle>