Da Vinci Payer Data Exchange
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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

: ExampleProvenancePayerSource - JSON Representation

Page standards status: Informative

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{
  "resourceType" : "Provenance",
  "id" : "1000005",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2020-07-12T18:26:23.217+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\"><p class=\"res-header-id\"><b>Generated Narrative: Provenance 1000005</b></p><a name=\"1000005\"> </a><a name=\"hc1000005\"> </a><a name=\"1000005-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: 2020-07-12 18:26:23+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://terminology.hl7.org/CodeSystem/provenance-participant-type author}\">Author</span></td><td><a href=\"Organization-Payer1.html\">Organization Payer 1</a></td></tr></table></div>"
  },
  "target" : [
    {
      🔗 "reference" : "MedicationDispense/1000001"
    }
  ],
  "recorded" : "2020-07-12T18:26:23.217+00:00",
  "agent" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
            "code" : "author",
            "display" : "Author"
          }
        ]
      },
      "who" : {
        🔗 "reference" : "Organization/Payer1"
      }
    }
  ],
  "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" : "ncpdp",
                "display" : "NCPDP Telecommunication"
              }
            ]
          }
        }
      ],
      "role" : "source",
      "what" : {
        "display" : "No reference available"
      }
    }
  ]
}