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 - XML Representation

Page standards status: Informative

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<Provenance xmlns="http://hl7.org/fhir">
  <id value="1000005"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-07-12T18:26:23.217+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"><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>
  </text>
  <target>🔗 
    <reference value="MedicationDispense/1000001"/>
  </target>
  <recorded value="2020-07-12T18:26:23.217+00:00"/>
  <agent>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
        <code value="author"/>
        <display value="Author"/>
      </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="ncpdp"/>
          <display value="NCPDP Telecommunication"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <role value="source"/>
    <what>
      <display value="No reference available"/>
    </what>
  </entity>
</Provenance>