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. This is the current published version. For a full list of available versions, see the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Questionnaire Task example - JSON Representation

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{
  "resourceType" : "Task",
  "id" : "questionnaire-example",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"questionnaire-example\"> </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;questionnaire-example&quot; </p></div><p><b>basedOn</b>: <a href=\"MedicationRequest-example.html\">MedicationRequest/example</a></p><p><b>status</b>: ready</p><p><b>intent</b>: order</p><p><b>code</b>: Complete 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>#complete-questionnaire)</span></p><p><b>for</b>: <a href=\"Patient-example.html\">Patient/example</a> &quot; SHAW&quot;</p><p><b>encounter</b>: <a href=\"Encounter-example.html\">Encounter/example</a></p><p><b>authoredOn</b>: 2018-08-09</p><p><b>requester</b>: <a href=\"http://example.org/fhir/Organization/payer\">http://example.org/fhir/Organization/payer</a></p><p><b>reasonCode</b>: Needed for prior authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-temp.html\">CRD Temporary Codes</a>#reason-prior-auth)</span></p><blockquote><p><b>input</b></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/Questionnaire/XYZ\">http://example.org/Questionnaire/XYZ|2</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Response Endpoint <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>#response-endpoint)</span></p><p><b>value</b>: <a href=\"http://example.org/somePayer\">http://example.org/somePayer</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: After-completion action <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-temp.html\">CRD Temporary Codes</a>#after-completion-action)</span></p><p><b>value</b>: Include in prior authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-temp.html\">CRD Temporary Codes</a>#prior-auth-include)</span></p></blockquote></div>"
  },
  "basedOn" : [
    {
      🔗 "reference" : "MedicationRequest/example"
    }
  ],
  "status" : "ready",
  "intent" : "order",
  "code" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
        "code" : "complete-questionnaire"
      }
    ]
  },
  "for" : {
    🔗 "reference" : "Patient/example"
  },
  "encounter" : {
    🔗 "reference" : "Encounter/example"
  },
  "authoredOn" : "2018-08-09",
  "requester" : {
    "reference" : "http://example.org/fhir/Organization/payer"
  },
  "reasonCode" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
        "code" : "reason-prior-auth"
      }
    ],
    "text" : "Needed for prior authorization"
  },
  "input" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
            "code" : "questionnaire"
          }
        ]
      },
      "valueCanonical" : "http://example.org/Questionnaire/XYZ|2"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
            "code" : "response-endpoint"
          }
        ]
      },
      "valueUrl" : "http://example.org/somePayer"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
            "code" : "after-completion-action"
          }
        ]
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
            "code" : "prior-auth-include",
            "display" : "Include in prior authorization"
          }
        ]
      }
    }
  ]
}