This page is part of the Da Vinci Clinical Documentation Exchange (v2.1.0-snapshot: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
Page standards status: Informative |
<Task xmlns="http://hl7.org/fhir">
<id value="cdex-task-example27"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Task cdex-task-example27</b></p><a name="cdex-task-example27"> </a><a name="hccdex-task-example27"> </a><a name="cdex-task-example27-en-US"> </a><p><b>status</b>: Completed</p><p><b>intent</b>: order</p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp data-request-questionnaire}">Data Request Questionnaire</span></p><p><b>for</b>: Identifier: Member Number/Member123</p><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-19 12:00:00+0000</p><p><b>requester</b>: Identifier: <code>http://example.org/cdex/payer/payer-ids</code>/Payer123</p><p><b>owner</b>: Identifier: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/9941339108</p><p><b>reasonReference</b>: Identifier: Payer Claim ID/Claim123</p><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/uv/sdc/CodeSystem/temp questionnaire}">Questionnaire</span></p><p><b>value</b>: <a href="Questionnaire-cdex-questionnaire-example1.html">Home Oxygen Therapy Questionnaire</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp purpose-of-use}">Purpose Of Use</span></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActReason COVERAGE}">coverage under policy or program</span></p></blockquote><h3>Outputs</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/uv/sdc/CodeSystem/temp questionnaire-response}">Questionnaire Response</span></td><td><a href="QuestionnaireResponse-cdex-questionnaireresponse-example1.html">Response to Questionnaire '->Home Oxygen Therapy Questionnaire' about '->display: string (PrimitiveType/QuestionnaireResponse.subject.display): element = string -> display=string[Amy Shaw]'</a></td></tr></table></div>
</text>
<status value="completed"/>
<intent value="order"/>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
<code value="data-request-questionnaire"/>
</coding>
</code>
<for>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
<display value="Member Number"/>
</coding>
<text value="Member Number"/>
</type>
<system value="http://example.org/cdex/payer/member-ids"/>
<value value="Member123"/>
</identifier>
</for>
<authoredOn value="2022-06-17T16:16:06Z"/>
<lastModified value="2022-06-19T12:00:00Z"/>
<requester>
<identifier>
<system value="http://example.org/cdex/payer/payer-ids"/>
<value value="Payer123"/>
</identifier>
</requester>
<owner>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339108"/>
</identifier>
</owner>
<reasonReference>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="FILL"/>
<display value="Filler Identifier"/>
</coding>
<text value="Payer Claim ID"/>
</type>
<system value="http://example.org/cdex/payer/claim-ids"/>
<value value="Claim123"/>
</identifier>
</reasonReference>
<input>
<type>
<coding>
<system value="http://hl7.org/fhir/uv/sdc/CodeSystem/temp"/>
<code value="questionnaire"/>
</coding>
</type>
<valueCanonical value="http://example.org/cdex-questionnaire-example1"/>
</input>
<input>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
<code value="purpose-of-use"/>
</coding>
</type>
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="COVERAGE"/>
</coding>
</valueCodeableConcept>
</input>
<output>
<type>
<coding>
<system value="http://hl7.org/fhir/uv/sdc/CodeSystem/temp"/>
<code value="questionnaire-response"/>
</coding>
</type>
<valueReference>🔗
<reference
value="QuestionnaireResponse/cdex-questionnaireresponse-example1"/>
</valueReference>
</output>
</Task>