This page is part of the Da Vinci Clinical Documentation Exchange (v1.0.0: STU1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions
<Parameters xmlns="http://hl7.org/fhir">
<id value="cdex-submit-attachment-example"/>
<meta>
<extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
<valueString value="CDex Submit Attachment Parameters Resource Example"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/instance-description">
<valueMarkdown
value="Parameters Resource example showing how it is used when the `$submit-attachment` operation is invoked. It represents the collection of named parameters including the "attachment" (additional information) and data to re-associate the attachmenet to a claim or prior authorization."/>
</extension>
</meta>
<parameter>
<name value="AttachTo"/>
<valueCode value="claim"/>
</parameter>
<parameter>
<name value="TargetId"/>
<valueString value="11234657"/>
</parameter>
<parameter>
<name value="ItemId"/>
<valueString value="1"/>
</parameter>
<parameter>
<name value="OrganizationId"/>
<valueIdentifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1407071236"/>
</valueIdentifier>
</parameter>
<parameter>
<name value="ProviderId"/>
<valueIdentifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339108"/>
</valueIdentifier>
</parameter>
<parameter>
<name value="MemberId"/>
<valueIdentifier>
<system value="http://example.org/cdex/member-ids"/>
<value value="234567"/>
</valueIdentifier>
</parameter>
<parameter>
<name value="Attachment"/>
<resource>
<Bundle>
<id value="cdex-document-digital-sig-example"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:c173535e-135e-48e3-ab64-38bacc68dba8"/>
</identifier>
<type value="document"/>
<timestamp value="2021-10-25T20:16:29-07:00"/>
<entry>
<fullUrl value="urn:uuid:17a80a8d-4cf1-4deb-a1fd-2db1130e5f76"/>
<resource>
<Composition>
<id value="17a80a8d-4cf1-4deb-a1fd-2db1130e5f76"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "17a80a8d-4cf1-4deb-a1fd-2db1130e5f76" </p></div><p><b>status</b>: final</p><p><b>type</b>: Medical records <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#11503-0)</span></p><p><b>encounter</b>: <a href="#Encounter_5ce5c83a-000f-47d2-941c-039358cc9112">See above (urn:uuid:5ce5c83a-000f-47d2-941c-039358cc9112: Example Encounter)</a></p><p><b>date</b>: 2021-10-25T20:16:29-07:00</p><p><b>author</b>: <a href="#Practitioner_0820c16d-91de-4dfa-a3a6-f140a516a9bc">See above (urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc: Example Practitioner)</a></p><p><b>title</b>: Active Conditions</p><h3>Attesters</h3><table class="grid"><tr><td>-</td><td><b>Mode</b></td><td><b>Time</b></td><td><b>Party</b></td></tr><tr><td>*</td><td>legal</td><td>2021-10-25T20:16:29-07:00</td><td><a href="#Practitioner_0820c16d-91de-4dfa-a3a6-f140a516a9bc">See above (urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc: Example Practitioner)</a></td></tr></table></div>
</text>
<status value="final"/>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="11503-0"/>
</coding>
<text value="Medical records"/>
</type>
<subject>
<reference value="urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece"/>
<display value="Example Patient"/>
</subject>
<encounter>
<reference value="urn:uuid:5ce5c83a-000f-47d2-941c-039358cc9112"/>
<display value="Example Encounter"/>
</encounter>
<date value="2021-10-25T20:16:29-07:00"/>
<author>
<reference value="urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc"/>
<display value="Example Practitioner"/>
</author>
<title value="Active Conditions"/>
<attester>
<mode value="legal"/>
<time value="2021-10-25T20:16:29-07:00"/>
<party>
<reference
value="urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc"/>
<display value="Example Practitioner"/>
</party>
</attester>
<section>
<title value="Active Condition 1"/>
<entry>
<reference
value="urn:uuid:014a68ec-d691-49e0-b980-91b0d924e570"/>
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc"/>
<resource>
<Practitioner>
<id value="0820c16d-91de-4dfa-a3a6-f140a516a9bc"/>
<meta>
<lastUpdated value="2013-05-05T16:13:03+00:00"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "0820c16d-91de-4dfa-a3a6-f140a516a9bc" Updated "2013-05-05T16:13:03Z" </p></div><p><b>name</b>: John Hancock </p></div>
</text>
<name>
<family value="Hancock"/>
<given value="John"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece"/>
<resource>
<Patient>
<id value="970af6c9-5bbd-4067-b6c1-d9b2c823aece"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "970af6c9-5bbd-4067-b6c1-d9b2c823aece" </p></div><p><b>active</b>: true</p><p><b>name</b>: CDEX Example Patient</p></div>
</text>
<active value="true"/>
<name>
<text value="CDEX Example Patient"/>
<family value="Patient"/>
<given value="CDEX Example"/>
</name>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:014a68ec-d691-49e0-b980-91b0d924e570"/>
<resource>
<Condition>
<id value="014a68ec-d691-49e0-b980-91b0d924e570"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "014a68ec-d691-49e0-b980-91b0d924e570" </p></div><p><b>identifier</b>: id: 1</p><p><b>clinicalStatus</b>: Active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.0.0/CodeSystem-condition-clinical.html">Condition Clinical Status Codes</a>#active)</span></p><p><b>category</b>: Problem <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#55607006; <a href="https://loinc.org/">LOINC</a>#75326-9)</span></p><p><b>code</b>: Type 2 Diabetes Mellitus <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#44054006)</span></p><p><b>subject</b>: <a href="#Patient_970af6c9-5bbd-4067-b6c1-d9b2c823aece">See above (urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece)</a></p><p><b>onset</b>: 2006-01-01</p><p><b>asserter</b>: <a href="#Practitioner_0820c16d-91de-4dfa-a3a6-f140a516a9bc">See above (urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc)</a></p></div>
</text>
<identifier>
<system value="urn:oid:1.3.6.1.4.1.22812.4.111.0.4.1.2.1"/>
<value value="1"/>
</identifier>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="55607006"/>
<display value="Problem"/>
</coding>
<coding>
<system value="http://loinc.org"/>
<code value="75326-9"/>
<display value="Problem"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="44054006"/>
<display value="Type 2 Diabetes Mellitus"/>
</coding>
</code>
<subject>
<reference value="urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece"/>
</subject>
<onsetDateTime value="2006"/>
<asserter>
<reference value="urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc"/>
</asserter>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:5ce5c83a-000f-47d2-941c-039358cc9112"/>
<resource>
<Encounter>
<id value="5ce5c83a-000f-47d2-941c-039358cc9112"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "5ce5c83a-000f-47d2-941c-039358cc9112" </p></div><p><b>status</b>: finished</p><p><b>class</b>: emergency (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code EMER = 'emergency', stated as 'null')</p><p><b>type</b>: Unknown (qualifier value) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#261665006)</span></p><p><b>subject</b>: <a href="#Patient_970af6c9-5bbd-4067-b6c1-d9b2c823aece">See above (urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece: CDEX Example Patient)</a></p><h3>Participants</h3><table class="grid"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href="#Practitioner_0820c16d-91de-4dfa-a3a6-f140a516a9bc">See above (urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc: John Hancock)</a></td></tr></table><p><b>period</b>: 2021-10-25T20:10:29-07:00 --> 2021-10-25T20:16:29-07:00</p><p><b>serviceProvider</b>: <a href="#Organization_e37f004b-dc10-422b-b833-cdaa10a055a3">See above (urn:uuid:e37f004b-dc10-422b-b833-cdaa10a055a3: CDEX Example Organization)</a></p></div>
</text>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="EMER"/>
</class>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="261665006"/>
<display value="Unknown (qualifier value)"/>
</coding>
<text value="Unknown (qualifier value)"/>
</type>
<subject>
<reference value="urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece"/>
<display value="CDEX Example Patient"/>
</subject>
<participant>
<individual>
<reference
value="urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc"/>
<display value="John Hancock"/>
</individual>
</participant>
<period>
<start value="2021-10-25T20:10:29-07:00"/>
<end value="2021-10-25T20:16:29-07:00"/>
</period>
<serviceProvider>
<reference value="urn:uuid:e37f004b-dc10-422b-b833-cdaa10a055a3"/>
<display value="CDEX Example Organization"/>
</serviceProvider>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:e37f004b-dc10-422b-b833-cdaa10a055a3"/>
<resource>
<Organization>
<id value="e37f004b-dc10-422b-b833-cdaa10a055a3"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "e37f004b-dc10-422b-b833-cdaa10a055a3" </p></div><p><b>active</b>: true</p><p><b>name</b>: CDEX Example Organization</p><p><b>telecom</b>: ph: (+1) 555-555-5555, <a href="mailto:customer-service@example.org">customer-service@example.org</a></p><p><b>address</b>: 1 CDEX Lane Boston MA 01002 USA </p></div>
</text>
<active value="true"/>
<name value="CDEX Example Organization"/>
<telecom>
<system value="phone"/>
<value value="(+1) 555-555-5555"/>
</telecom>
<telecom>
<system value="email"/>
<value value="customer-service@example.org"/>
</telecom>
<address>
<line value="1 CDEX Lane"/>
<city value="Boston"/>
<state value="MA"/>
<postalCode value="01002"/>
<country value="USA"/>
</address>
</Organization>
</resource>
</entry>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.5"/>
<display value="Verification Signature"/>
</type>
<when value="2021-10-05T22:42:19-07:00"/>
<who>
<reference value="https://example.org/Practitioner/123"/>
</who>
<onBehalfOf>
<reference value="https://example.org/Organization/123"/>
</onBehalfOf>
<data
value="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"/>
</signature>
</Bundle>
</resource>
</parameter>
</Parameters>