This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v1.1.0-ballot: STU 1.1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
Generated Narrative
Resource "annotated-example"
Coverage Information
value: Prior Authorization (Details: http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverageGuidance code prior-auth = 'Prior authorization', stated as 'Prior Authorization')
value: Coverage/example
value: 2019-02-15
status: draft
intent: original-order
medication: Cellcept 250 MG Oral Capsule (RxNorm#616447)
subject: http://example.org/Patient/123: Jane Smith
encounter: http://example.org/Encounter/ABC
authoredOn: 2019-02-15
requester: http://example.org/PractitionerRole/987: Dr. Jones
note: Unsolicited prior authorization for Jane Smith to receive 6 tablets Cellcept 250 MG Oral Capsule BID granted. Please note prior authorization # 12345 on claim submission. (By XYZ Insurance @Feb 15, 2019 8:07:18 PM)