Da Vinci Payer Data Exchange
1.0.0 - STU1

This page is part of the Da Vinci Payer Data Exchange (v1.0.0: STU1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: BundleWithProvenance - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "3000002",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/StructureDefinition/Bundle"
    ]
  },
  "type" : "searchset",
  "timestamp" : "2020-09-28T23:26:23.217+00:00",
  "total" : 1,
  "entry" : [
    {
      "fullUrl" : "https://example.com/base/MedicationDispense/1000001",
      "resource" : {
        "resourceType" : "MedicationDispense",
        "id" : "1000001",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>medication</b>: <span title=\"Codes: {http://hl7.org/fhir/sid/ndc 54458-872-10}\">30 TABLET in 1 BLISTER PACK (54458-872-10)</span></p><p><b>subject</b>: <a href=\"Patient-1.html\">Generated Summary: language: en-US; Member Number: https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901, Medical record number: 1234-234-1243-12345678901m, Health Plan Identifier: 1234-234-1243-12345678901u, Patient external identifier: 1234-234-1243-12345678901a; active; Johnny Appleseed ; Phone: (410)678-2323; gender: male; birthDate: 1986-01-01; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></a></p><h3>Performers</h3><table class=\"grid\"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href=\"Practitioner-4.html\">Generated Summary: National Provider Identifier: 874635264; Susan Smith ; Phone: 3015551234; gender: female; birthDate: 1965-11-15</a></td></tr></table><p><b>location</b>: <a href=\"Location-5.html\">Generated Summary: name: MyFavorite Pharmacy</a></p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-ActCode RF}\">Refill</span></p><p><b>quantity</b>: 60</p><p><b>daysSupply</b>: 30</p></div>"
        },
        "status" : "completed",
        "medicationCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://hl7.org/fhir/sid/ndc",
              "code" : "54458-872-10"
            }
          ]
        },
        "subject" : {
          "reference" : "Patient/1"
        },
        "performer" : [
          {
            "actor" : {
              "reference" : "Practitioner/4"
            }
          }
        ],
        "location" : {
          "reference" : "Location/5"
        },
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code" : "RF"
            }
          ]
        },
        "quantity" : {
          "value" : 60
        },
        "daysSupply" : {
          "value" : 30
        }
      }
    },
    {
      "fullUrl" : "https://example.com/base/Provenance/321000001",
      "resource" : {
        "resourceType" : "Provenance",
        "id" : "321000001",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2020-09-28T23:26:23.217+00:00",
          "profile" : [
            "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>target</b>: <a href=\"#MedicationDispense_1000001\">See above (MedicationDispense/1000001)</a></p><p><b>recorded</b>: Jul 12, 2020 6:26:23 PM</p><h3>Agents</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Who</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type transmitter}\">Transmitter</span></td><td><a href=\"Organization-2.html\">Generated Summary: language: en-US; National Provider Identifier: 345678; active; name: Payer 1</a></td></tr></table><h3>Entities</h3><table class=\"grid\"><tr><td>-</td><td><b>Extension</b></td><td><b>Role</b></td><td><b>What</b></td></tr><tr><td>*</td><td></td><td>source</td><td><span>No reference available</span></td></tr></table></div>"
        },
        "target" : [
          {
            "reference" : "MedicationDispense/1000001"
          }
        ],
        "recorded" : "2020-07-12T18:26:23.217+00:00",
        "agent" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type",
                  "code" : "transmitter",
                  "display" : "Transmitter"
                }
              ]
            },
            "who" : {
              "reference" : "Organization/2"
            }
          }
        ],
        "entity" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource",
                      "code" : "hl7ccda",
                      "display" : "HL7 C-CDA"
                    }
                  ]
                }
              }
            ],
            "role" : "source",
            "what" : {
              "display" : "No reference available"
            }
          }
        ]
      }
    }
  ]
}