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

: ExampleProvenancePayerSource - JSON Representation

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{
  "resourceType" : "Provenance",
  "id" : "1000004",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2020-07-12T18:26:23.217+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.html\">Generated Summary: status: completed; <span title=\"Codes: {http://hl7.org/fhir/sid/ndc 54458-872-10}\">30 TABLET in 1 BLISTER PACK (54458-872-10)</span>; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-ActCode RF}\">Refill</span>; 60; 30</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://terminology.hl7.org/CodeSystem/provenance-participant-type author}\">Author</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://terminology.hl7.org/CodeSystem/provenance-participant-type",
            "code" : "author",
            "display" : "Author"
          }
        ]
      },
      "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" : "ncpdp",
                "display" : "NCPDP Telecommunication"
              }
            ]
          }
        }
      ],
      "role" : "source",
      "what" : {
        "display" : "No reference available"
      }
    }
  ]
}