This Section describes the expected capabilities of the PDEX Server actor which is responsible for providing responses to the queries submitted by the PDEX Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by PDEX Servers are defined. PDEX Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Returns dispensed prescriptions for a specific patient. NOTE: This Pdex SearchParameter definition extends the usage context of capabilitystatement-expectation extension to formally express implementer conformance expectations for these elements:

• multipleAnd
• multipleOr
• comparator
• modifier
• chain.

Status of the prescription dispense. NOTE: This SearchParameter definition extends the usage context of capabilitystatement-expectation extension to formally express implementer conformance expectations for these elements:

• multipleAnd
• multipleOr
• comparator
• modifier
• chain.

The HRex Coverage Profile defines the constraints for representing a member’s healthcare insurance information to the Payer. Coverage instances complying with this profile, sometimes together with the Patient which this profile references via beneficiary, allows a payer to identify a member in their system.

The PDex Device profile is provided to enable payers to record information about devices used by a member that may not have a UDI number.

Prescription Medications dispensed by a pharmacy to a health plan member and paid for in full, or in part, by the health plan

Provenance is provided by the payer to identify the source of the information, whether the data came via a clinical record or a claim record and whether the data was subject to manual transcription or other interpretive transformation. This profile adds PayerSourceFormat as an extension on the entity base element.

Attribute that identifies the refill number of a prescription. e.g. 0, 1, 2, etc.

Attributes that identify the source record format from which data in the referenced resources was derived

The Drug Listing Act of 1972 requires registered drug establishments to provide the Food and Drug Administration (FDA) with a current list of all drugs manufactured, prepared, propagated, compounded, or processed by it for commercial distribution. (See Section 510 of the Federal Food, Drug, and Cosmetic Act (Act) (21 U.S.C. § 360)). Drug products are identified and reported using a unique, three-segment number, called the National Drug Code (NDC), which serves as a universal product identifier for drugs. FDA publishes the listed NDC numbers and the information submitted as part of the listing information in the NDC Directory which is updated daily.

The information submitted as part of the listing process, the NDC number, and the NDC Directory are used in the implementation and enforcement of the Act.

Users should note:

Starting June 1, 2011, only drugs for which electronic listings (SPL) have been submitted to FDA are included in the NDC Directory. Drugs for which listing information was last submitted to FDA on paper forms, prior to June 2009, are included on a separate file and will not be updated after June 2012.

Information regarding the FDA published NDC Directory can be found here

Users should note a few important items

• The NDC Directory is updated daily.
• The new NDC Directory contains ONLY information on final marketed drugs submitted to FDA in SPL electronic listing files by labelers.
• The NDC Directory does not contain all listed drugs. The new version includes the final marketed drugs which listing information were submitted electronically. It does not include animal drugs, blood products, or human drugs that are not in final marketed form, such as Active Pharmaceutical Ingredients(APIs), drugs for further processing, drugs manufactured exclusively for a private label distributor, or drugs that are marketed solely as part of a kit or combination product or inner layer of a multi-level packaged product not marketed individually. For more information about how certain kits or multi-level packaged drugs are addressed in the new NDC Directory, see the NDC Directory Package File definitions document. For the FDA Online Label Repository page and additional resources go to: FDA Online Label Repository

Agent role performed relating to referenced resource

Source Data formats used as the source for FHIR referenced record by the Payer.

Identifier Type

CodeSystem for types of role relating to the creation or communication of referenced resources

CodeSystem for source formats that identify what non-FHIR source was used to create FHIR record(s)

Example of a US Core Patient Record

Example of a MedicationDispense from a Claim

Example of a Transmitter Provenance record for a bundle

Example of an author Provenance record displaying a practitioner’s organization as the author

Example of an author Provenance record displaying a sole practitioner as the author

Example of an payer being the source of the data

Example of provenance based on security group recommendations

Example of a PDex Provenance record for a PDF embedded or linked in a DocumentReference resource.

Example of a Transmitter Provenance record for a bundle

Example of a US Core DocumentReference with a linked PDF document. The document could also be embedded.

Example of the Payer Organization

A simple bundle to demonstrate a provenance example

Provider Organization Example 1

A bundle that returns provenance using _revinclude=Provenance:target

Example of a Practitioner Record

Example of a Pharmacy Location Record

Example of a Device from a Claim

Example of an Encounter that has a provenance record

Example of an Encounter that has a provenance record

Example of a Coverage for a Member

Payer Data Exchange Server Capability Statement