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
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Bundle ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "1000000-1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/StructureDefinition/Bundle"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/StructureDefinition/Bundle> ] )
] ; #
fhir:type [ fhir:v "transaction-response"] ; #
fhir:timestamp [ fhir:v "2019-12-31T20:26:23.217+00:00"^^xsd:dateTime] ; #
fhir:link ( [
fhir:relation [ fhir:v "self" ] ;
fhir:url [ fhir:v "https://example.com/base/fhir/Patient?ct=W2idG9rZW4iOiIrUklEOn53MThjQUk5RlVPZ0lEQUFBQUFBQU"^^xsd:anyURI ]
] ) ; #
fhir:entry ( [
fhir:fullUrl [ fhir:v "https://example.com/base/Patient/1"^^xsd:anyURI ] ;
( fhir:resource <https://example.com/base/Patient/1> ) ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] [
fhir:fullUrl [ fhir:v "https://example.com/base/Encounter/6-1"^^xsd:anyURI ] ;
( fhir:resource <https://example.com/base/Encounter/6-1> ) ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] [
fhir:fullUrl [ fhir:v "https://example.com/base/Encounter/7-1"^^xsd:anyURI ] ;
( fhir:resource <https://example.com/base/Encounter/7-1> ) ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] [
fhir:fullUrl [ fhir:v "https://example.com/base/Provenance/1000002-1"^^xsd:anyURI ] ;
( fhir:resource <https://example.com/base/Provenance/1000002-1> ) ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] [
fhir:fullUrl [ fhir:v "https://example.com/base/Provenance/1000003-1"^^xsd:anyURI ] ;
( fhir:resource <https://example.com/base/Provenance/1000003-1> ) ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] [
fhir:fullUrl [ fhir:v "https://example.com/base/Provenance/1000004-1"^^xsd:anyURI ] ;
( fhir:resource <https://example.com/base/Provenance/1000004-1> ) ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] ) . #
<https://example.com/base/Patient/1> a fhir:Patient ;
fhir:id [ fhir:v "1"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2019-07-07T13:26:22.0314215+00:00"^^xsd:dateTime ] ;
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient> ] )
] ; #
fhir:language [ fhir:v "en-US"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:identifier ( [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "https://www.xxxhealthplan.com/fhir/memberidentifier"^^xsd:anyURI ] ;
fhir:value [ fhir:v "https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901" ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MR" ] ] ) ] ;
fhir:system [ fhir:v "https://www.xxxhealthplan.com/fhir/medicalrecordnumber"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234-234-1243-12345678901m" ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "XV" ] ] ) ] ;
fhir:system [ fhir:v "https://www.xxxhealthplan.com/fhir/uniquememberidentifier"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234-234-1243-12345678901u" ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PT" ] ] ) ] ;
fhir:system [ fhir:v "https://www.xxxhealthplan.com/fhir/patacctnum"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234-234-1243-12345678901a" ]
] ) ; #
fhir:active [ fhir:v "true"^^xsd:boolean] ; #
fhir:name ( [
fhir:family [ fhir:v "Appleseed" ] ;
( fhir:given [ fhir:v "Johnny" ] )
] ) ; #
fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "(443)555-1212" ] ;
fhir:rank [ fhir:v "1"^^xsd:positiveInteger ]
] [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "(410)678-2323" ] ;
fhir:rank [ fhir:v "2"^^xsd:positiveInteger ]
] ) ; #
fhir:gender [ fhir:v "male"] ; #
fhir:birthDate [ fhir:v "1986-01-01"^^xsd:date] ; #
fhir:address ( [
fhir:type [ fhir:v "physical" ] ;
( fhir:line [ fhir:v "123 Main Street" ] ) ;
fhir:city [ fhir:v "Pittsburgh" ] ;
fhir:state [ fhir:v "PA" ] ;
fhir:postalCode [ fhir:v "12519" ]
] ) ; #
fhir:maritalStatus [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-NullFlavor"^^xsd:anyURI ] ;
fhir:code [ fhir:v "UNK" ] ] )
] . #
<https://example.com/base/Encounter/6-1> a fhir:Encounter ;
fhir:id [ fhir:v "6-1"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2019-07-14T19:26:23.217+00:00"^^xsd:dateTime ] ;
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:status [ fhir:v "finished"] ; #
fhir:class [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "AMB" ] ;
fhir:display [ fhir:v "Ambulatory" ]
] ; #
fhir:type ( [
( fhir:coding [
a sct:11429006 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:version [ fhir:v "http://snomed.info/sct/731000124108" ] ;
fhir:code [ fhir:v "11429006" ] ;
fhir:display [ fhir:v "Consultation" ] ] )
] ) ; #
fhir:subject [
fhir:reference [ fhir:v "Patient/1" ]
] . #
<https://example.com/base/Encounter/7-1> a fhir:Encounter ;
fhir:id [ fhir:v "7-1"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2019-10-15T20:26:23.217+00:00"^^xsd:dateTime ] ;
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:status [ fhir:v "finished"] ; #
fhir:class [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "AMB" ] ;
fhir:display [ fhir:v "Ambulatory" ]
] ; #
fhir:type ( [
( fhir:coding [
a sct:11429006 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:version [ fhir:v "http://snomed.info/sct/731000124108" ] ;
fhir:code [ fhir:v "11429006" ] ;
fhir:display [ fhir:v "Consultation" ] ] )
] ) ; #
fhir:subject [
fhir:reference [ fhir:v "Patient/1" ]
] . #
<https://example.com/base/Provenance/1000002-1> a fhir:Provenance ;
fhir:id [ fhir:v "1000002-1"] ; #
fhir:meta [
fhir:versionId [ fhir:v "1" ] ;
fhir:lastUpdated [ fhir:v "2019-07-14T19:26:23.217+00:00"^^xsd:dateTime ] ;
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:target ( [
fhir:link <https://example.com/base/Encounter/6-1> ;
fhir:reference [ fhir:v "https://example.com/base/Encounter/6-1" ]
] ) ; #
fhir:recorded [ fhir:v "2020-07-10T16:26:23.217+00:00"^^xsd:dateTime] ; #
fhir:agent ( [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/provenance-participant-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "author" ] ;
fhir:display [ fhir:v "Author" ] ] ) ] ;
fhir:who [
fhir:reference [ fhir:v "Organization/ProviderOrg1" ] ]
] ) ; #
fhir:entity ( [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource"^^xsd:anyURI ] ;
fhir:code [ fhir:v "hl7ccda" ] ;
fhir:display [ fhir:v "HL7 C-CDA" ] ] ) ] ] ) ;
fhir:role [ fhir:v "source" ] ;
fhir:what [
fhir:display [ fhir:v "No reference available" ] ]
] ) . #
<https://example.com/base/Provenance/1000003-1> a fhir:Provenance ;
fhir:id [ fhir:v "1000003-1"] ; #
fhir:meta [
fhir:versionId [ fhir:v "1" ] ;
fhir:lastUpdated [ fhir:v "2019-10-15T20:26:23.217+00:00"^^xsd:dateTime ]
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:target ( [
fhir:reference [ fhir:v "Encounter/7-1" ]
] ) ; #
fhir:recorded [ fhir:v "2020-07-10T16:26:23.217+00:00"^^xsd:dateTime] ; #
fhir:agent ( [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/provenance-participant-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "author" ] ;
fhir:display [ fhir:v "Author" ] ] ) ] ;
fhir:who [
fhir:reference [ fhir:v "Organization/ProviderOrg1" ] ]
] ) ; #
fhir:entity ( [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource"^^xsd:anyURI ] ;
fhir:code [ fhir:v "hl7ccda" ] ;
fhir:display [ fhir:v "HL7 C-CDA" ] ] ) ] ] ) ;
fhir:role [ fhir:v "source" ] ;
fhir:what [
fhir:display [ fhir:v "No reference available" ] ]
] ) . #
<https://example.com/base/Provenance/1000004-1> a fhir:Provenance ;
fhir:id [ fhir:v "1000004-1"] ; #
fhir:meta [
fhir:versionId [ fhir:v "1" ] ;
fhir:lastUpdated [ fhir:v "2019-12-31T20:26:23.217+00:00"^^xsd:dateTime ]
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:target ( [
fhir:reference [ fhir:v "Bundle/1000000-1" ]
] ) ; #
fhir:recorded [ fhir:v "2019-12-31T20:26:23.217+00:00"^^xsd:dateTime] ; #
fhir:agent ( [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "transmitter" ] ;
fhir:display [ fhir:v "Transmitter" ] ] ) ] ;
( fhir:role [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/contractsignertypecodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "TRANS" ] ] ) ] ) ;
fhir:who [
fhir:reference [ fhir:v "Organization/Payer1" ] ]
] ) . #
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
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