Da Vinci Payer Data Exchange
2.1.0-ballot - STU2 Ballot
Da Vinci Payer Data Exchange
2.1.0-ballot - STU2 Ballot
This page is part of the Da Vinci Payer Data Exchange (v2.1.0-ballot: STU2.1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "1000000-1",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Bundle"
]
},
"type" : "transaction-response",
"timestamp" : "2019-12-31T20:26:23.217+00:00",
"link" : [
{
"relation" : "self",
"url" : "https://example.com/base/fhir/Patient?ct=W2idG9rZW4iOiIrUklEOn53MThjQUk5RlVPZ0lEQUFBQUFBQU"
}
],
"entry" : [
{
"fullUrl" : "https://example.com/base/Patient/1",
"resource" : {
"resourceType" : "Patient",
"id" : "1",
"meta" : {
"lastUpdated" : "2019-07-07T13:26:22.0314215+00:00",
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"language" : "en-US",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><a name=\"Patient_1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient 1</b></p><a name=\"1\"> </a><a name=\"hc1\"> </a><a name=\"1-en-US\"> </a><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\">Last updated: 2019-07-07 13:26:22+0000; Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Ids (see the one above)\">Other Ids:</td><td colspan=\"3\"><ul><li>Medical record number/1234-234-1243-12345678901m</li><li>Health Plan Identifier/1234-234-1243-12345678901u</li><li>Patient external identifier/1234-234-1243-12345678901a</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: (443)555-1212</li><li>ph: (410)678-2323</li><li>123 Main Street Pittsburgh PA 12519 </li></ul></td></tr></table></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB"
}
]
},
"system" : "https://www.xxxhealthplan.com/fhir/memberidentifier",
"value" : "https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR"
}
]
},
"system" : "https://www.xxxhealthplan.com/fhir/medicalrecordnumber",
"value" : "1234-234-1243-12345678901m"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "XV"
}
]
},
"system" : "https://www.xxxhealthplan.com/fhir/uniquememberidentifier",
"value" : "1234-234-1243-12345678901u"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PT"
}
]
},
"system" : "https://www.xxxhealthplan.com/fhir/patacctnum",
"value" : "1234-234-1243-12345678901a"
}
],
"active" : true,
"name" : [
{
"family" : "Appleseed",
"given" : [
"Johnny"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(443)555-1212",
"rank" : 1
},
{
"system" : "phone",
"value" : "(410)678-2323",
"rank" : 2
}
],
"gender" : "male",
"birthDate" : "1986-01-01",
"address" : [
{
"type" : "physical",
"line" : [
"123 Main Street"
],
"city" : "Pittsburgh",
"state" : "PA",
"postalCode" : "12519"
}
],
"maritalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
"code" : "UNK"
}
]
}
},
"response" : {
"status" : "200"
}
},
{
"fullUrl" : "https://example.com/base/Encounter/6-1",
"resource" : {
"resourceType" : "Encounter",
"id" : "6-1",
"meta" : {
"lastUpdated" : "2019-07-14T19:26:23.217+00:00",
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_6-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter 6-1</b></p><a name=\"6-1\"> </a><a name=\"hc6-1\"> </a><a name=\"6-1-en-US\"> </a><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\">Last updated: 2019-07-14 19:26:23+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: Finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode</a> AMB: Ambulatory</p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 11429006}\">Consultation</span></p><p><b>subject</b>: <a href=\"Patient-1.html\">Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)</a></p></div>"
},
"status" : "finished",
"class" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "AMB",
"display" : "Ambulatory"
},
"type" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"version" : "http://snomed.info/sct/731000124108",
"code" : "11429006",
"display" : "Consultation"
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/1"
}
},
"response" : {
"status" : "200"
}
},
{
"fullUrl" : "https://example.com/base/Encounter/7-1",
"resource" : {
"resourceType" : "Encounter",
"id" : "7-1",
"meta" : {
"lastUpdated" : "2019-10-15T20:26:23.217+00:00",
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_7-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter 7-1</b></p><a name=\"7-1\"> </a><a name=\"hc7-1\"> </a><a name=\"7-1-en-US\"> </a><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\">Last updated: 2019-10-15 20:26:23+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: Finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode</a> AMB: Ambulatory</p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 11429006}\">Consultation</span></p><p><b>subject</b>: <a href=\"Patient-1.html\">Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)</a></p></div>"
},
"status" : "finished",
"class" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "AMB",
"display" : "Ambulatory"
},
"type" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"version" : "http://snomed.info/sct/731000124108",
"code" : "11429006",
"display" : "Consultation"
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/1"
}
},
"response" : {
"status" : "200"
}
},
{
"fullUrl" : "https://example.com/base/Provenance/1000002-1",
"resource" : {
"resourceType" : "Provenance",
"id" : "1000002-1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2019-07-14T19:26:23.217+00:00",
"profile" : [
🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_1000002-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance 1000002-1</b></p><a name=\"1000002-1\"> </a><a name=\"hc1000002-1\"> </a><a name=\"1000002-1-en-US\"> </a><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\">version: 1; Last updated: 2019-07-14 19:26:23+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-pdex-provenance.html\">PDex Provenance</a></p></div><p>Provenance for <a href=\"Bundle-1000000-1.html#https-//example.com/base/Encounter/6-1\">Bundle: type = transaction-response; timestamp = 2019-12-31 20:26:23+0000</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2020-07-10 16:26:23+0000</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type author}\">Author</span></td><td><a href=\"Organization-ProviderOrg1.html\">Organization Provider 1</a></td></tr></table></div>"
},
"target" : [
{
"reference" : "https://example.com/base/Encounter/6-1"
}
],
"recorded" : "2020-07-10T16:26:23.217+00:00",
"agent" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
"code" : "author",
"display" : "Author"
}
]
},
"who" : {
🔗 "reference" : "Organization/ProviderOrg1"
}
}
],
"entity" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource",
"code" : "hl7ccda",
"display" : "HL7 C-CDA"
}
]
}
}
],
"role" : "source",
"what" : {
"display" : "No reference available"
}
}
]
},
"response" : {
"status" : "200"
}
},
{
"fullUrl" : "https://example.com/base/Provenance/1000003-1",
"resource" : {
"resourceType" : "Provenance",
"id" : "1000003-1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2019-10-15T20:26:23.217+00:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_1000003-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance 1000003-1</b></p><a name=\"1000003-1\"> </a><a name=\"hc1000003-1\"> </a><a name=\"1000003-1-en-US\"> </a><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\">version: 1; Last updated: 2019-10-15 20:26:23+0000</p></div><p>Provenance for <a href=\"Bundle-1000000-1.html#Encounter_7-1\">Bundle: type = transaction-response; timestamp = 2019-12-31 20:26:23+0000</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2020-07-10 16:26:23+0000</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type author}\">Author</span></td><td><a href=\"Organization-ProviderOrg1.html\">Organization Provider 1</a></td></tr></table></div>"
},
"target" : [
{
"reference" : "Encounter/7-1"
}
],
"recorded" : "2020-07-10T16:26:23.217+00:00",
"agent" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
"code" : "author",
"display" : "Author"
}
]
},
"who" : {
🔗 "reference" : "Organization/ProviderOrg1"
}
}
],
"entity" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource",
"code" : "hl7ccda",
"display" : "HL7 C-CDA"
}
]
}
}
],
"role" : "source",
"what" : {
"display" : "No reference available"
}
}
]
},
"response" : {
"status" : "200"
}
},
{
"fullUrl" : "https://example.com/base/Provenance/1000004-1",
"resource" : {
"resourceType" : "Provenance",
"id" : "1000004-1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2019-12-31T20:26:23.217+00:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_1000004-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance 1000004-1</b></p><a name=\"1000004-1\"> </a><a name=\"hc1000004-1\"> </a><a name=\"1000004-1-en-US\"> </a><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\">version: 1; Last updated: 2019-12-31 20:26:23+0000</p></div><p>Provenance for <a href=\"Bundle-1000000-1.html\">Bundle: type = transaction-response; timestamp = 2019-12-31 20:26:23+0000</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2019-12-31 20:26:23+0000</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>Type</b></td><td><b>Role</b></td><td><b>who</b></td></tr><tr><td><span title=\"Codes:{http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type transmitter}\">Transmitter</span></td><td/><td><a href=\"Organization-Payer1.html\">Organization Payer 1</a></td></tr></table></div>"
},
"target" : [
{
🔗 "reference" : "Bundle/1000000-1"
}
],
"recorded" : "2019-12-31T20:26:23.217+00:00",
"agent" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type",
"code" : "transmitter",
"display" : "Transmitter"
}
]
},
"role" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "TRANS"
}
]
}
],
"who" : {
🔗 "reference" : "Organization/Payer1"
}
}
]
},
"response" : {
"status" : "200"
}
}
]
}
IG © 2024+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pdex#2.1.0-ballot based on FHIR 4.0.1. Generated 2024-08-14
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change