Common CQL Assets for FHIR (US-Based)
1.0.0-ballot - STU 1 Ballot
Publication Build: This will be filled in by the publication tooling
Official URL: http://hl7.org/fhir/us/cql/Questionnaire/ExamplePatientAndCoverageQuestionnaire | Version: 1.0.0-ballot | |||
Standards status: Informative | Computable Name: ExamplePatientAndCoverageQuestionnaire |
For the Prior Authorization Questionnaire Use Case, this type of in-context information is expected to be known already so it wouldn't typically be in a Questionnaire. This example illustrates how to get this information if it is needed.
Generated Narrative: Questionnaire ExamplePatientAndCoverageQuestionnaire
LinkID | Text | Cardinality | Type | Description & Constraints |
---|---|---|---|---|
![]() ![]() | For the Prior Authorization Questionnaire Use Case, this type of in-context information is expected to be known already so it wouldn't typically be in a Questionnaire. This example illustrates how to get this information if it is needed. | Questionnaire | http://hl7.org/fhir/us/cql/Questionnaire/ExamplePatientAndCoverageQuestionnaire#1.0.0-ballot | |
![]() ![]() ![]() | Patient Information | 0..1 | group | |
![]() ![]() ![]() ![]() | Name | 0..1 | string | |
![]() ![]() ![]() ![]() | Date of Birth | 0..1 | date | |
![]() ![]() ![]() ![]() | Birth Sex | 0..1 | choice | Value Set: Birth Sex |
![]() ![]() ![]() ![]() | Medical Record Number | 0..1 | string | |
![]() ![]() ![]() ![]() | Phone Number | 0..1 | string | |
![]() ![]() ![]() ![]() | Email Address | 0..1 | string | |
![]() ![]() ![]() ![]() | Address | 0..1 | string | |
![]() ![]() ![]() ![]() | City | 0..1 | string | |
![]() ![]() ![]() ![]() | State | 0..1 | string | |
![]() ![]() ![]() ![]() | Postal Code | 0..1 | string | |
![]() ![]() ![]() | Coverage Information | 0..1 | group | |
![]() ![]() ![]() ![]() | Member ID | 0..1 | string | |
![]() ![]() ![]() ![]() | Policy Number | 0..1 | string | |
![]() ![]() ![]() | Requesting Provider Information | 0..1 | group | |
![]() ![]() ![]() ![]() | Requesting provider name | 0..1 | string | |
![]() ![]() ![]() ![]() | Phone | 0..1 | string | |
![]() ![]() ![]() ![]() | Ordering provider address | 0..1 | string | |
![]() ![]() ![]() ![]() | Ordering provider Tax ID/NPI # | 0..1 | string | |
![]() ![]() ![]() ![]() | Fax | 0..1 | string | |
![]() ![]() ![]() | Laboratory performing testing/Servicing Provider | 0..1 | group | |
![]() ![]() ![]() ![]() | Servicing Provider name | 0..1 | string | |
![]() ![]() ![]() ![]() | Phone | 0..1 | string | |
![]() ![]() ![]() ![]() | Ordering provider address | 0..1 | string | |
![]() ![]() ![]() ![]() | Ordering provider Tax ID/NPI # | 0..1 | string | |
![]() ![]() ![]() ![]() | Fax | 0..1 | string | |