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

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: BundleWithProvenance - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="3000002"/>
  <meta>
    <profile value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
  </meta>
  <type value="searchset"/>
  <timestamp value="2020-09-28T23:26:23.217+00:00"/>
  <total value="1"/>
  <link>
    <relation value="self"/>
    <url
         value="https://example.com/base/fhir/MedicationDispense?ct=W3sidG9rZW4iOiIrUklEOn53MThjQUk5RlVPZ0lEQUFBQUFBQU"/>
  </link>
  <entry>
    <fullUrl value="https://example.com/base/MedicationDispense/1000001"/>
    <resource>
      <MedicationDispense>
        <id value="1000001"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicationDispense_1000001"> </a><p class="res-header-id"><b>Generated Narrative: MedicationDispense 1000001</b></p><a name="1000001"> </a><a name="hc1000001"> </a><a name="1000001-en-US"> </a><p><b>status</b>: Completed</p><p><b>medication</b>: <span title="Codes:{http://hl7.org/fhir/sid/ndc 54458-872-10}">Lisinopril, 30 TABLET in 1 BLISTER PACK (54458-872-10) (package)</span></p><p><b>subject</b>: <a href="Patient-1.html">Johnny Appleseed  Male, DoB: 1986-01-01 ( Member Number)</a></p><h3>Performers</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Actor</b></td></tr><tr><td style="display: none">*</td><td><a href="Practitioner-4.html">Practitioner Susan Smith </a></td></tr></table><p><b>location</b>: <a href="Location-5.html">Location MyFavorite Pharmacy</a></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode RF}">Refill</span></p><p><b>quantity</b>: 60</p><p><b>daysSupply</b>: 30</p></div>
        </text>
        <status value="completed"/>
        <medicationCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/sid/ndc"/>
            <code value="54458-872-10"/>
          </coding>
        </medicationCodeableConcept>
        <subject>🔗 
          <reference value="Patient/1"/>
        </subject>
        <performer>
          <actor>🔗 
            <reference value="Practitioner/4"/>
          </actor>
        </performer>
        <location>🔗 
          <reference value="Location/5"/>
        </location>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
            <code value="RF"/>
          </coding>
        </type>
        <quantity>
          <value value="60"/>
        </quantity>
        <daysSupply>
          <value value="30"/>
        </daysSupply>
      </MedicationDispense>
    </resource>
    <search>
      <mode value="match"/>
    </search>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/321000001"/>
    <resource>
      <Provenance>
        <id value="321000001"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2020-09-28T23:26:23.217+00:00"/>
          <profile
                   value="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Provenance_321000001"> </a><p class="res-header-id"><b>Generated Narrative: Provenance 321000001</b></p><a name="321000001"> </a><a name="hc321000001"> </a><a name="321000001-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: 2020-09-28 23:26:23+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-pdex-provenance.html">PDex Provenance</a></p></div><p>Provenance for <a href="MedicationDispense-1000001.html">MedicationDispense: extension = 1; status = completed; medication[x] = Lisinopril, 30 TABLET in 1 BLISTER PACK (54458-872-10) (package); type = Refill; quantity = 60; daysSupply = 30; whenHandedOver = 2024-04-15 09:00:23+0000</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2020-07-12 18:26:23+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://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type transmitter}">Transmitter</span></td><td><a href="Organization-Payer1.html">Organization Payer 1</a></td></tr></table></div>
        </text>
        <target>🔗 
          <reference value="MedicationDispense/1000001"/>
        </target>
        <recorded value="2020-07-12T18:26:23.217+00:00"/>
        <agent>
          <type>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type"/>
              <code value="transmitter"/>
              <display value="Transmitter"/>
            </coding>
          </type>
          <who>🔗 
            <reference value="Organization/Payer1"/>
          </who>
        </agent>
        <entity>
          <extension
                     url="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource"/>
                <code value="hl7ccda"/>
                <display value="HL7 C-CDA"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <role value="source"/>
          <what>
            <display value="No reference available"/>
          </what>
        </entity>
      </Provenance>
    </resource>
    <search>
      <mode value="include"/>
    </search>
  </entry>
</Bundle>