{
  "resourceType": "Procedure",
  "id": "HCBS",
  "basedOn": [
    {
      "display": "Peter's Long Term Service and Supports (LTSS) Care Plan"
    }
  ],
  "status": "completed",
  "code": {
    "coding": [
      {
        "system": "https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html",
        "code": "T1019",
        "display": "Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment."
      }
    ],
    "text": "Personal care services"
  },
  "subject": {
    "reference": "Patient/example",
    "display": "Peter James"
  },
  "performedDateTime": "2018-04-05",
  "performer": [
    {
      "actor": {
        "reference": "Practitioner/example",
        "display": "Adam Careful"
      }
    }
  ],
  "location": {
    "reference": "Location/ph",
    "display": "Peter's Home"
  },
  "note": [
    {
      "text": "Assisted with bathing and dressing, doing laundry, and meal preparation"
    }
  ],
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}