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 |
{
"resourceType" : "Task",
"contained" : [
{
"resourceType" : "Patient",
"id" : "patient",
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB",
"display" : "Member Number"
}
],
"text" : "Member Number"
},
"system" : "http://example.org/cdex/payer/member-ids",
"value" : "Member123"
}
],
"name" : [
{
"family" : "Shaw",
"given" : [
"Amy"
]
}
],
"birthDate" : "1987-02-20"
},
{
"resourceType" : "PractitionerRole",
"id" : "practitionerrole",
"practitioner" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
"organization" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1234567893"
}
}
}
],
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "tracking-id",
"display" : "Tracking Id"
}
],
"text" : "Re-Association Tracking Control Number"
},
"system" : "http://example.org/payer",
"value" : "trackingid123"
}
],
"status" : "requested",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
"code" : "attachment-request-code"
}
],
"text" : "Coded Attachment Request"
},
"for" : {
"reference" : "#patient"
},
"authoredOn" : "2022-06-17T16:16:06Z",
"lastModified" : "2022-06-17T16:16:06Z",
"requester" : {
"identifier" : {
"system" : "http://example.org/cdex/payer/payer-ids",
"value" : "Payer123"
}
},
"owner" : {
"reference" : "#practitionerrole"
},
"reasonCode" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/claim-use",
"code" : "claim",
"display" : "Claim"
}
],
"text" : "claim"
},
"reasonReference" : {
"identifier" : {
"system" : "http://example.org/cdex/payer/claim-ids",
"value" : "Claim123"
}
},
"restriction" : {
"period" : {
"end" : "2022-06-21"
}
},
"input" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber",
"valueInteger" : 1
}
],
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
"code" : "attachments-needed"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11506-3",
"display" : "Progress note"
}
],
"text" : "Progress note"
}
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "signature-flag"
}
]
},
"valueBoolean" : true
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
"code" : "payer-url"
}
]
},
"valueUrl" : "http://example.org/cdex/payer/$submit-attachment"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "service-date"
}
]
},
"valueDate" : "2022-06-13"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "purpose-of-use"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"code" : "CLMATTCH",
"display" : "claim attachment"
}
]
}
}
]
}