Da Vinci Clinical Data Exchange (CDex)
2.0.0 - STU2 United States of America flag

This page is part of the Da Vinci Clinical Documentation Exchange (v2.0.0: STU2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: CDex Task Example 23 - JSON Representation

Page standards status: Informative

Raw json | Download


{
  "resourceType" : "Task",
  "id" : "cdex-task-example23",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"cdex-task-example23\"> </a></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 Task &quot;cdex-task-example23&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdex-task-attachment-request.html\">CDex Task Attachment Request Profile</a></p></div><p><b>identifier</b>: Re-Association Tracking Control Number:\u00a0trackingid1034</p><p><b>status</b>: requested</p><p><b>intent</b>: order</p><p><b>code</b>: Attachment Request Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#attachment-request-questionnaire)</span></p><p><b>for</b>: <a name=\"patient\"> </a></p><blockquote><p/><p><a name=\"patient\"> </a></p><p><b>identifier</b>: Member Number:\u00a0Member123\u00a0(use:\u00a0USUAL), Patient Account Number:\u00a0PA-123\u00a0(use:\u00a0USUAL)</p><p><b>name</b>: Amy Shaw </p><p><b>birthDate</b>: 1987-02-20</p></blockquote><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-17 16:16:06+0000</p><p><b>requester</b>: <span/></p><p><b>owner</b>: <a name=\"practitionerrole\"> </a></p><blockquote><p/><p><a name=\"practitionerrole\"> </a></p><p><b>practitioner</b>: <span/></p><p><b>organization</b>: <span/></p></blockquote><p><b>reasonCode</b>: preauthorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-claim-use.html\">Use</a>#preauthorization &quot;Preauthorization&quot;)</span></p><p><b>reasonReference</b>: <span/></p><h3>Restrictions</h3><table class=\"grid\"><tr><td>-</td><td><b>Period</b></td></tr><tr><td>*</td><td>?? --&gt; 2022-06-21</td></tr></table><blockquote><p><b>input</b></p><p><b>ServiceLineNumber</b>: 1</p><p><b>type</b>: Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/uv/sdc/STU3/CodeSystem-temp.html\">Temporary SDC Codes</a>#questionnaire)</span></p><p><b>value</b>: <a href=\"http://example.org/base_adaptive_questionnaire\">http://example.org/base_adaptive_questionnaire</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Signature Flag <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#signature-flag)</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Payer URL <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#payer-url)</span></p><p><b>value</b>: <a href=\"http://example.org/cdex/payer/$submit-attachment\">http://example.org/cdex/payer/$submit-attachment</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Purpose Of Use <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#purpose-of-use)</span></p><p><b>value</b>: coverage authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ActReason.html\">ActReason</a>#COVAUTH)</span></p></blockquote><hr/><blockquote><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Amy Shaw </b> (no stated gender), DoB: 1987-02-20 ( Member Number:\u00a0Member123\u00a0(use:\u00a0USUAL))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Other Ids (see the one above)\">Other Id:</td><td colspan=\"3\">Patient Account Number:\u00a0PA-123\u00a0(use:\u00a0USUAL)</td></tr></table></blockquote><hr/><blockquote><p><b>Generated Narrative: PractitionerRole #practitionerrole</b><a name=\"practitionerrole\"> </a></p><p><b>practitioner</b>: <span/></p><p><b>organization</b>: <span/></p></blockquote></div>"
  },
  "contained" : [
    {
      "resourceType" : "Patient",
      "id" : "patient",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics"
        ]
      },
      "identifier" : [
        {
          "use" : "usual",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-hrex/CodeSystem/hrex-temp",
                "code" : "UMB",
                "display" : "Member Number"
              }
            ],
            "text" : "Member Number"
          },
          "system" : "http://example.org/cdex/payer/member-ids",
          "value" : "Member123"
        },
        {
          "use" : "usual",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType",
                "code" : "pat",
                "display" : "Patient Account Number"
              }
            ],
            "text" : "Patient Account Number"
          },
          "system" : "http://example.org/cdex/provider/patient-ids",
          "value" : "PA-123"
        }
      ],
      "name" : [
        {
          "family" : "Shaw",
          "given" : [
            "Amy"
          ]
        }
      ],
      "birthDate" : "1987-02-20"
    },
    {
      "resourceType" : "PractitionerRole",
      "id" : "practitionerrole",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-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" : "trackingid1034"
    }
  ],
  "status" : "requested",
  "intent" : "order",
  "code" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
        "code" : "attachment-request-questionnaire"
      }
    ],
    "text" : "Attachment Request Questionnaire"
  },
  "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" : "preauthorization",
        "display" : "Preauthorization"
      }
    ],
    "text" : "preauthorization"
  },
  "reasonReference" : {
    "identifier" : {
      "system" : "http://example.org/cdex/payer/claim-ids",
      "value" : "Preauth123"
    }
  },
  "restriction" : {
    "period" : {
      "end" : "2022-06-21"
    }
  },
  "input" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber",
          "valuePositiveInt" : 1
        }
      ],
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
            "code" : "questionnaire"
          }
        ]
      },
      "valueCanonical" : "http://example.org/base_adaptive_questionnaire"
    },
    {
      "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-cdex/CodeSystem/cdex-temp",
            "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" : "purpose-of-use"
          }
        ]
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
            "code" : "COVAUTH",
            "display" : "coverage authorization"
          }
        ]
      }
    }
  ]
}