<Bundle xmlns="http://hl7.org/fhir">
<id value="44420ed9-7388-4be5-acc5-9c124fad9f34"/>
<meta>
<versionId value="1"/>
<profile
value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Bundle|1.4"/>
</meta>
<identifier>
<system
value="https://gematik.de/fhir/erp/NamingSystem/GEM_ERP_NS_PrescriptionId"/>
<value value="160.100.000.000.006.24"/>
</identifier>
<type value="document"/>
<timestamp value="2024-05-20T08:30:00Z"/>
<entry>
<fullUrl value="urn:uuid:6ac6d8bc-3acd-4e31-ad9b-442fc343c6c0"/>
<resource>
<Composition>
<id value="6ac6d8bc-3acd-4e31-ad9b-442fc343c6c0"/>
<meta>
<versionId value="1"/>
<profile
value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Composition|1.4"/>
</meta>
<extension
url="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_Legal_basis">
<valueCoding>
<system
value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_STATUSKENNZEICHEN"/>
<code value="00"/>
</valueCoding>
</extension>
<status value="final"/>
<type>
<coding>
<system
value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_FORMULAR_ART"/>
<code value="e16A"/>
</coding>
</type>
<subject>
<reference value="urn:uuid:93866fdc-3e50-4902-a7e9-891b54737b5e"/>
</subject>
<date value="2024-05-20T08:00:00Z"/>
<author>
<reference value="urn:uuid:bc329f24-3d65-4286-bf06-b54dd6cad655"/>
<type value="Practitioner"/>
</author>
<author>
<type value="Device"/>
<identifier>
<system
value="https://fhir.kbv.de/NamingSystem/KBV_NS_FOR_Pruefnummer"/>
<value value="Y/400/2107/36/999"/>
</identifier>
</author>
<title value="elektronische Arzneimittelverordnung"/>
<custodian>
<reference value="urn:uuid: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="urn:uuid:000abe24-f690-481e-9a9f-1cd0eb434e2f"/>
</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="urn:uuid:1b89236c-ab14-4e92-937e-5af0b59d0cd4"/>
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:000abe24-f690-481e-9a9f-1cd0eb434e2f"/>
<resource>
<MedicationRequest>
<id value="000abe24-f690-481e-9a9f-1cd0eb434e2f"/>
<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="0"/>
</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="false"/>
</extension>
<status value="active"/>
<intent value="order"/>
<medicationReference>
<reference value="urn:uuid:47076fb4-dc5c-4f75-85f6-b200033b3280"/>
</medicationReference>
<subject>
<reference value="urn:uuid:93866fdc-3e50-4902-a7e9-891b54737b5e"/>
</subject>
<authoredOn value="2024-05-20"/>
<requester>
<reference value="urn:uuid:bc329f24-3d65-4286-bf06-b54dd6cad655"/>
</requester>
<basedOn>
<identifier>
<system value="https://gematik.de/fhir/sid/emp-identifier"/>
<value value="8cc8e04b-6df7-43b5-b847-508268e95ba7"/>
</identifier>
</basedOn>
<insurance>
<reference value="urn:uuid:1b89236c-ab14-4e92-937e-5af0b59d0cd4"/>
</insurance>
<dispenseRequest>
<quantity>
<value value="1"/>
<unit value="Packung"/>
</quantity>
</dispenseRequest>
<substitution>
<allowedBoolean value="true"/>
</substitution>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:47076fb4-dc5c-4f75-85f6-b200033b3280"/>
<resource>
<Medication>
<id value="47076fb4-dc5c-4f75-85f6-b200033b3280"/>
<meta>
<versionId value="1"/>
<profile
value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_PZN|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="763158003"/>
<display value="Medicinal product (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>
<extension url="http://fhir.de/StructureDefinition/normgroesse">
<valueCode value="N1"/>
</extension>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/ifa/pzn"/>
<code value="00814665"/>
</coding>
<text value="Januvia® 50 mg 28 Filmtabletten N1"/>
</code>
<form>
<coding>
<system
value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
<code value="FTA"/>
</coding>
</form>
<ingredient>
<itemCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/ask"/>
<code value="34150"/>
</coding>
<text value="Sitagliptin"/>
</itemCodeableConcept>
<strength>
<numerator>
<value value="50"/>
<unit value="mg"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="Stück"/>
</denominator>
</strength>
</ingredient>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:93866fdc-3e50-4902-a7e9-891b54737b5e"/>
<resource>
<Patient>
<id value="93866fdc-3e50-4902-a7e9-891b54737b5e"/>
<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="K220635158"/>
</identifier>
<name>
<use value="official"/>
<family value="Königsstein">
<extension
url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
<valueString value="Königsstein"/>
</extension>
</family>
<given value="Ludger"/>
</name>
<birthDate value="1935-06-22"/>
<address>
<type value="both"/>
<line value="Blumenweg">
<extension
url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
<valueString value="Blumenweg"/>
</extension>
</line>
<city value="Esens"/>
<postalCode value="26427"/>
<country value="D"/>
</address>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:bc329f24-3d65-4286-bf06-b54dd6cad655"/>
<resource>
<Practitioner>
<id value="bc329f24-3d65-4286-bf06-b54dd6cad655"/>
<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="123456628"/>
</identifier>
<name>
<use value="official"/>
<family value="Freiherr von Müller">
<extension
url="http://hl7.org/fhir/StructureDefinition/humanname-own-prefix">
<valueString value="von"/>
</extension>
<extension
url="http://fhir.de/StructureDefinition/humanname-namenszusatz">
<valueString value="Freiherr"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
<valueString value="Müller"/>
</extension>
</family>
<given value="Paul"/>
<prefix value="Dr. med.">
<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="Facharzt für Innere Medizin: Kardiologie"/>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid: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="urn:uuid:1b89236c-ab14-4e92-937e-5af0b59d0cd4"/>
<resource>
<Coverage>
<id value="1b89236c-ab14-4e92-937e-5af0b59d0cd4"/>
<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="05"/>
</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="17"/>
</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="5"/>
</valueCoding>
</extension>
<status value="active"/>
<type>
<coding>
<system
value="http://fhir.de/CodeSystem/versicherungsart-de-basis"/>
<code value="GKV"/>
</coding>
</type>
<beneficiary>
<reference value="urn:uuid:93866fdc-3e50-4902-a7e9-891b54737b5e"/>
</beneficiary>
<payor>
<identifier>
<system value="http://fhir.de/sid/arge-ik/iknr"/>
<value value="109719018"/>
</identifier>
<display value="AOK Nordost"/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>