This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions
| Page standards status: Informative |
Generated Narrative: MedicationRequest
Resource MedicationRequest "annotated-example"
Coverage Information
url
coveragevalue: Coverage/example
url
coveredvalue: conditional
url
pa-neededvalue: satisfied
url
doc-neededvalue: admin
url
doc-purposevalue: withclaim
url
info-neededvalue: performer
url
billingCodevalue: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed (Details: http://www.ama-assn.org/go/cpt code 77067 = 'Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed', stated as 'null')
url
reasonvalue: In-network required unless exigent circumstances (CRD Temporary Codes#gold-card)
code: Authorization out-of-network only (CRD Temporary Codes#auth-out-network-only)
url
detailurl
questionnairevalue: http://example.org/some-payer/Questionnaire/123|1.3.0
url
responsequestionnaire: http://example.org/some-payer/Questionnaire/123|1.3.0
status: in-progress
subject: http://example.org/Patient/123: Jane Smith
authored: 2019-02-15
author: : Some payer app name
item
linkId: A1234
text: How many previous treatments have been tried for this issue?
Answers
Value[x] 2 url
datevalue: 2019-02-15
url
coverage-assertion-idvalue: 12345ABC
url
satisfied-pa-idvalue: XXYYZ
url
contact
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)
dosageInstruction
text: 6 tablets every 12 hours.
timing: Once per 12 hours
doseAndRate
LinkId Text Definition Answer qr
Questionnaire:http://example.org/some-payer/Questionnaire/123|1.3.0 A1234
How many previous treatments have been tried for this issue? 2 Documentation for this format