Publication Build: This will be filled in by the publication tooling
Page standards status: Informative |
Generated Narrative: Task cdex-task-example31
status: Completed
intent: order
code: Data Request Questionnaire
for: Identifier: Member Number/Member123
authoredOn: 2022-06-17 16:16:06+0000
lastModified: 2022-06-18 16:16:06+0000
requester: Identifier: http://example.org/cdex/payer/payer-ids
/Payer123
owner: Identifier: United States National Provider Identifier/9941339108
reasonReference: Identifier: Payer Claim ID/Claim123
input
type: Questionnaire
input
type: Purpose Of Use
value: coverage under policy or program
input
type: Signature Flag
value: true