{
  "resourceType": "Bundle",
  "type": "transaction",
  "entry": [
    {
      "fullUrl": "urn:uuid:5ca8da35-efb1-498a-93bc-ed34524a360f",
      "resource": {
        "resourceType": "Patient",
        "identifier": [
          {
            "system": "urn:oid:2.16.858.1.858.1.1.1",
            "value": "123456789"
          }
        ],
        "active": true,
        "name": [
          {
            "use": "official",
            "family": "Pérez",
            "given": [
              "Juan"
            ]
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Patient"
      }
    },
    {
      "fullUrl": "urn:uuid:15f62e6b-f4d9-43d8-91f5-ee963a34339c",
      "resource": {
        "resourceType": "DocumentReference",
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "57133-1",
              "display": "Referral note"
            }
          ],
          "text": "Informe de Contra-referencia Dermatológica"
        },
        "subject": {
          "reference": "urn:uuid:5ca8da35-efb1-498a-93bc-ed34524a360f"
        },
        "date": "2026-04-23T07:50:00-03:00",
        "author": [
          {
            "display": "Dra. Especialista - Nodo Panamá"
          }
        ],
        "description": "Respuesta a interconsulta - Caso Dermatología",
        "content": [
          {
            "attachment": {
              "contentType": "application/fhir+json",
              "url": "urn:uuid:03e4a890-b152-481a-9ca5-685e03550a08"
            }
          }
        ],
        "context": {
          "related": [
            {
              "identifier": {
                "system": "https://salud.gub.uy/interconsultas",
                "value": "UY-PA-2026-998877"
              }
            }
          ]
        }
      },
      "request": {
        "method": "POST",
        "url": "DocumentReference"
      }
    },
    {
      "fullUrl": "urn:uuid:03e4a890-b152-481a-9ca5-685e03550a08",
      "resource": {
        "resourceType": "Bundle",
        "type": "document",
        "timestamp": "2026-04-23T07:50:00-03:00",
        "entry": [
          {
            "fullUrl": "urn:uuid:4d58cb4f-1f8b-4f94-9877-bb5a0de47955",
            "resource": {
              "resourceType": "Composition",
              "status": "final",
              "type": {
                "coding": [
                  {
                    "system": "http://loinc.org",
                    "code": "11488-4",
                    "display": "Consultation note"
                  }
                ]
              },
              "subject": {
                "reference": "urn:uuid:5ca8da35-efb1-498a-93bc-ed34524a360f"
              },
              "date": "2026-04-23T07:50:00-03:00",
              "author": [
                {
                  "display": "Dra. Especialista - Nodo Panamá"
                }
              ],
              "title": "Informe de Contra-referencia Dermatológica",
              "section": [
                {
                  "title": "Motivo de Interconsulta",
                  "code": {
                    "coding": [
                      {
                        "system": "http://loinc.org",
                        "code": "42349-1",
                        "display": "Reason for referral"
                      }
                    ]
                  },
                  "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Se solicita segunda opinión para evaluación de lesión pigmentada en región escapular, con el fin de descartar malignidad tras hallazgos clínicos iniciales en Uruguay.</p></div>"
                  }
                },
                {
                  "title": "Revisión de Evidencia",
                  "code": {
                    "coding": [
                      {
                        "system": "http://loinc.org",
                        "code": "30954-2",
                        "display": "Relevant diagnostic tests"
                      }
                    ]
                  },
                  "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Se re-evaluaron los resultados del IPS (Bundle/2313), específicamente el DiagnosticReport/biopsia-001 y las imágenes dermatoscópicas adjuntas.</p></div>"
                  }
                },
                {
                  "title": "Juicio Clínico",
                  "code": {
                    "coding": [
                      {
                        "system": "http://loinc.org",
                        "code": "51848-0",
                        "display": "Assessment note"
                      }
                    ]
                  },
                  "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Tras el análisis de la evidencia, se concluye que la morfología de la lesión es compatible con un Nevus Displásico. No se identifican criterios histológicos de melanoma.</p></div>"
                  }
                },
                {
                  "title": "Recomendaciones",
                  "code": {
                    "coding": [
                      {
                        "system": "http://loinc.org",
                        "code": "18776-5",
                        "display": "Plan of care"
                      }
                    ]
                  },
                  "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><ul><li>Control dermatoscópico cada 6 meses.</li><li>Uso de fotoprotección (FPS 50+).</li><li>No se requiere intervención quirúrgica inmediata.</li></ul></div>"
                  }
                }
              ]
            }
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "Bundle"
      }
    }
  ]
}