Aetna FHIR R4 DiagnosticReport

{
 "$schema": "https://json-schema.org/draft/2020-12/schema",
 "$id": "https://raw.githubusercontent.com/api-evangelist/aetna/refs/heads/main/json-schema/aetna-diagnosticreport.json",
 "title": "Aetna FHIR R4 DiagnosticReport",
 "description": "JSON Schema for the FHIR R4 DiagnosticReport resource as Aetna profiles it. Derived mechanically from the components.schemas of openapi/aetna-patient-access-api-openapi.yml, which is assembled from the Swagger 2.0 documents Aetna publishes at https://developerportal.aetna.com/managedcontent/yaml/. Not authored - every constraint here is Aetna's. $refs rewritten from #/components/schemas/ to #/$defs/.",
 "x-provenance": {
  "generated": "2026-08-30",
  "method": "derived",
  "source": "openapi/aetna-patient-access-api-openapi.yml"
 },
 "allOf": [
  {
   "$ref": "#/$defs/DomainResource"
  },
  {
   "type": "object",
   "required": [
    "code",
    "status"
   ],
   "properties": {
    "identifier": {
     "description": "Identifiers assigned to this report by the performer or other systems.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Identifier"
     }
    },
    "code": {
     "description": "A code or name that describes this diagnostic report.",
     "$ref": "#/$defs/CodeableConcept"
    },
    "performer": {
     "description": "The diagnostic service that is responsible for issuing the report.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Reference"
     }
    },
    "effectivePeriod": {
     "description": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
     "$ref": "#/$defs/Period"
    },
    "resultsInterpreter": {
     "description": "The practitioner or organization that is responsible for the report's conclusions and interpretations.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Reference"
     }
    },
    "subject": {
     "description": "The subject of the report. Usually, but not always, this is a patient. However, diagnostic services also perform analyses on specimens collected from a variety of other sources.",
     "$ref": "#/$defs/Reference"
    },
    "conclusionCode": {
     "description": "One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/CodeableConcept"
     }
    },
    "presentedForm": {
     "description": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Attachment"
     }
    },
    "encounter": {
     "description": "The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.",
     "$ref": "#/$defs/Reference"
    },
    "media": {
     "description": "A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).",
     "type": "array",
     "items": {
      "$ref": "#/$defs/DiagnosticReport_Media"
     }
    },
    "result": {
     "description": "[Observations](observation.html) that are part of this diagnostic report.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Reference"
     }
    },
    "conclusion": {
     "pattern": "[ \\r\\n\\t\\S]+",
     "description": "Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.",
     "type": "string"
    },
    "effectiveDateTime": {
     "pattern": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?)?)?",
     "description": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
     "type": "string"
    },
    "specimen": {
     "description": "Details about the specimens on which this diagnostic report is based.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Reference"
     }
    },
    "category": {
     "description": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/CodeableConcept"
     }
    },
    "issued": {
     "pattern": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00))",
     "description": "The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.",
     "type": "string"
    },
    "imagingStudy": {
     "description": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Reference"
     }
    },
    "basedOn": {
     "description": "Details concerning a service requested.",
     "type": "array",
     "items": {
      "$ref": "#/$defs/Reference"
     }
    },
    "status": {
     "description": "The status of the diagnostic report.",
     "type": "string",
     "enum": [
      "registered",
      "partial",
      "preliminary",
      "final",
      "amended",
      "corrected",
      "appended",
      "cancelled",
      "entered-in-error",
      "unknown"
     ]
    }
   }
  }
 ],
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     "type": "object",
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       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "Country - a nation as commonly understood or generally accepted.",
       "type": "string"
      },
      "period": {
       "description": "Time period when address was/is in use.",
       "$ref": "#/$defs/Period"
      },
      "city": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "The name of the city, town, suburb, village or other community or delivery center.",
       "type": "string"
      },
      "use": {
       "description": "The purpose of this address.",
       "type": "string",
       "enum": [
        "home",
        "work",
        "temp",
        "old",
        "billing"
       ]
      },
      "line": {
       "description": "This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.",
       "type": "array",
       "items": {
        "pattern": "[ \\r\\n\\t\\S]+",
        "type": "string"
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      },
      "district": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "The name of the administrative area (county).",
       "type": "string"
      },
      "postalCode": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "A postal code designating a region defined by the postal service.",
       "type": "string"
      },
      "text": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.",
       "type": "string"
      },
      "state": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).",
       "type": "string"
      },
      "type": {
       "description": "Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.",
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       "description": "Indicates when this particular annotation was made.",
       "type": "string"
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      "text": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "The text of the annotation in markdown format.",
       "type": "string"
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   ]
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     "$ref": "#/$defs/Element"
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    {
     "type": "object",
     "properties": {
      "data": {
       "pattern": "(\\s*([0-9a-zA-Z\\+\\=]){4}\\s*)+",
       "description": "The actual data of the attachment - a sequence of bytes, base64 encoded.",
       "type": "string"
      },
      "size": {
       "format": "int32",
       "description": "The number of bytes of data that make up this attachment (before base64 encoding, if that is done).",
       "type": "integer"
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      "language": {
       "pattern": "[^\\s]+(\\s[^\\s]+)*",
       "description": "The human language of the content. The value can be any valid value according to BCP 47.",
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       "description": "A label or set of text to display in place of the data.",
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      "contentType": {
       "pattern": "[^\\s]+(\\s[^\\s]+)*",
       "description": "Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.",
       "type": "string"
      },
      "url": {
       "pattern": "\\S*",
       "description": "A location where the data can be accessed.",
       "type": "string"
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      "hash": {
       "pattern": "(\\s*([0-9a-zA-Z\\+\\=]){4}\\s*)+",
       "description": "The calculated hash of the data using SHA-1. Represented using base64.",
       "type": "string"
      },
      "creation": {
       "pattern": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?)?)?",
       "description": "The date that the attachment was first created.",
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     "$ref": "#/$defs/Element"
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       "description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
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      },
      "text": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
       "type": "string"
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     }
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  "Coding": {
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    {
     "$ref": "#/$defs/Element"
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    {
     "type": "object",
     "properties": {
      "system": {
       "pattern": "\\S*",
       "description": "The identification of the code system that defines the meaning of the symbol in the code.",
       "type": "string"
      },
      "code": {
       "pattern": "[^\\s]+(\\s[^\\s]+)*",
       "description": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
       "type": "string"
      },
      "userSelected": {
       "description": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
       "type": "boolean"
      },
      "display": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "A representation of the meaning of the code in the system, following the rules of the system.",
       "type": "string"
      },
      "version": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
       "type": "string"
      }
     }
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  "ContactDetail": {
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     "$ref": "#/$defs/Element"
    },
    {
     "type": "object",
     "properties": {
      "name": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "The name of an individual to contact.",
       "type": "string"
      },
      "telecom": {
       "description": "The contact details for the individual (if a name was provided) or the organization.",
       "type": "array",
       "items": {
        "$ref": "#/$defs/ContactPoint"
       }
      }
     }
    }
   ]
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  "ContactPoint": {
   "allOf": [
    {
     "$ref": "#/$defs/Element"
    },
    {
     "type": "object",
     "properties": {
      "period": {
       "description": "Time period when the contact point was/is in use.",
       "$ref": "#/$defs/Period"
      },
      "system": {
       "description": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
       "type": "string",
       "enum": [
        "phone",
        "fax",
        "email",
        "pager",
        "url",
        "sms",
        "other"
       ]
      },
      "use": {
       "description": "Identifies the purpose for the contact point.",
       "type": "string",
       "enum": [
        "home",
        "work",
        "temp",
        "old",
        "mobile"
       ]
      },
      "rank": {
       "format": "int32",
       "description": "Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.",
       "type": "integer"
      },
      "value": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
       "type": "string"
      }
     }
    }
   ]
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  "Count": {
   "allOf": [
    {
     "$ref": "#/$defs/Quantity"
    },
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     "type": "object"
    }
   ]
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  "DiagnosticReport_Media": {
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       "description": "Reference to the image source.",
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      "comment": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
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       "type": "array",
       "items": {
        "$ref": "#/$defs/Extension"
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      },
      "text": {
       "description": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
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     "description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
     "type": "array",
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     "pattern": "[A-Za-z0-9\\-\\.]{1,64}",
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       "$ref": "#/$defs/Money"
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       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
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       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
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      "valueUuid": {
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       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
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      },
      "valueCodeableConcept": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/CodeableConcept"
      },
      "valueRatio": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Ratio"
      },
      "valueMarkdown": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valueAttachment": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Attachment"
      },
      "valueUsageContext": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/UsageContext"
      },
      "valueDateTime": {
       "pattern": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?)?)?",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valueInteger": {
       "format": "int32",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "integer"
      },
      "valueUnsignedInt": {
       "format": "int32",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "integer"
      },
      "valueHumanName": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/HumanName"
      },
      "valueQuantity": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Quantity"
      },
      "valueRelatedArtifact": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/RelatedArtifact"
      },
      "valueCanonical": {
       "pattern": "\\S*",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valueCount": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Count"
      },
      "valueId": {
       "pattern": "[A-Za-z0-9\\-\\.]{1,64}",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valueDecimal": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "number"
      },
      "valueCode": {
       "pattern": "[^\\s]+(\\s[^\\s]+)*",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valueDate": {
       "pattern": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valueOid": {
       "pattern": "urn:oid:[0-2](\\.(0|[1-9][0-9]*))+",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "url": {
       "pattern": "\\S*",
       "description": "Source of the definition for the extension code - a logical name or a URL.",
       "type": "string"
      },
      "valueAddress": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Address"
      },
      "valueContactPoint": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/ContactPoint"
      },
      "valueString": {
       "pattern": "[ \\r\\n\\t\\S]+",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valuePeriod": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Period"
      },
      "valueSampledData": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/SampledData"
      },
      "valueTiming": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Timing"
      },
      "valueInstant": {
       "pattern": "([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00))",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "string"
      },
      "valuePositiveInt": {
       "format": "int32",
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "type": "integer"
      },
      "valueDuration": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Duration"
      },
      "valueAge": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Age"
      },
      "valueAnnotation": {
       "description": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
       "$ref": "#/$defs/Annotation"
      }
     }
    }
   ]
  },
  "HumanName": {
   "allOf": [
    {
     "$ref": "#/$defs/Element"
    },
    {
     "type": "object",
     "properties": {
      "given": {
       "description": "Given name.",
       "type": "array",
       "items": {
        "pattern": "[ \\r\\n\\t\\S]+",
        "type": "string"
       }
      },
      "period": {
       "description": "Indicates the period of time when this name was valid for the named person.",
       "$ref": "#/$defs/Period"
      },
      "use": {
       "description": "Identifies the purpose for this name.",
       "type": "string",
       "enum": [
        "usual",
        "official",
        "temp",
        "nickname",
        "anonymous",
        "old",
        "maiden"
       ]
      },
      "pre

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