Da Vinci - Documentation Templates and Rules
2.1.0 - STU 2.1

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## : $questionnaire-package Input Parameters Example - XML Representation

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    <Parameters xmlns="http://hl7.org/fhir">
      <id value="QuestionnairePackageInputParamsExample"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-qpackage-input-parameters"/>
      </meta>
      <parameter>
        <name value="coverage"/>
        <resource>
          <Coverage>
            <id value="CoverageExample"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage"/>
            </meta>
            <contained>
              <Organization>
                <id value="OrgExample"/>
                <meta>
                  <profile
                           value="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization"/>
                </meta>
                <identifier>
                  <system value="urn:oid:2.16.840.1.113883.4.7"/>
                  <value value="10D0202020"/>
                </identifier>
                <active value="true"/>
                <type>
                  <coding>
                    <system
                            value="http://terminology.hl7.org/CodeSystem/organization-type"/>
                    <code value="pay"/>
                    <display value="Payer"/>
                  </coding>
                </type>
                <name value="Insurance Company"/>
                <telecom>
                  <system value="phone"/>
                  <value value="860-547-5001"/>
                  <use value="work"/>
                </telecom>
                <address>
                  <line value="680 Asylum Street"/>
                  <city value="Hartford"/>
                  <state value="CT"/>
                  <postalCode value="06155"/>
                  <country value="US"/>
                </address>
              </Organization>
            </contained>
            <status value="active"/>
            <subscriber>🔗
              <reference value="Patient/examplepatient"/>
            </subscriber>
            <subscriberId value="PFP123450000"/>
            <beneficiary>🔗
              <reference value="Patient/examplepatient"/>
            </beneficiary>
            <relationship>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
                <code value="self"/>
                <display value="Self"/>
              </coding>
            </relationship>
            <period>
              <start value="2022-01-01"/>
              <end value="2023-01-01"/>
            </period>
            <payor>
              <reference value="#OrgExample"/>
            </payor>
            <class>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
                  <code value="plan"/>
                  <display value="Plan"/>
                </coding>
              </type>
              <value value="Premim Family Plus"/>
              <name value="Premim Family Plus Plan"/>
            </class>
          </Coverage>
        </resource>
      </parameter>
      <parameter>
        <name value="order"/>
        <resource>
          <ServiceRequest>
            <id value="ServiceRequestExample"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest"/>
            </meta>
            <status value="active"/>
            <intent value="original-order"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="24338-6"/>
              </coding>
              <text value="Gas panel - Blood"/>
            </code>
            <subject>🔗
              <reference value="Patient/examplepatient"/>
            </subject>
            <occurrenceDateTime value="2019-05-08T09:33:27+07:00"/>
            <authoredOn value="2019-09-18T07:53:21+07:00"/>
            <requester>🔗
              <reference value="Practitioner/PractitionerExample"/>
            </requester>
            <reasonCode>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="4565000"/>
              </coding>
              <text value="Decreased oxygen affinity"/>
            </reasonCode>
          </ServiceRequest>
        </resource>
      </parameter>
      <parameter>
        <name value="questionnaire"/>
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-dtr/Questionnaire/home-o2-std-questionnaire"/>
      </parameter>
    </Parameters>