Da Vinci Payer Data Exchange
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This page is part of the Da Vinci Payer Data Exchange (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: BundleExamplePayer2 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "1000000-2",
  "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=W4sidG9rZW4iOiIrUklEOn53MThjQUk5RlVPZ0lEQUFBQUFBQU"
    }
  ],
  "entry" : [
    {
      "fullUrl" : "https://example.com/base/Patient/1-2",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "1-2",
        "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\"><p><b>Generated Narrative: Patient</b><a name=\"1-2\"> </a></p><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\">Resource Patient &quot;1-2&quot; Updated &quot;2019-07-07 13:26:22+0000&quot;  (Language &quot;en-US&quot;) </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><p><b>identifier</b>: Member Number:\u00a0https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901, Medical record number:\u00a01234-234-1243-12345678901m, Health Plan Identifier:\u00a01234-234-1243-12345678901u, Patient external identifier:\u00a01234-234-1243-12345678901a</p><p><b>active</b>: true</p><p><b>name</b>: Johnny Appleseed </p><p><b>telecom</b>: ph: (443)555-1212, ph: (410)678-2323</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1986-01-01</p><p><b>address</b>: 123 Main Street Pittsburgh PA 12519 </p><p><b>maritalStatus</b>: unknown <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-NullFlavor.html\">NullFlavor</a>#UNK)</span></p></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/6-1-2",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "6-1-2",
        "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\"><p><b>Generated Narrative: Encounter</b><a name=\"6-1-2\"> </a></p><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\">Resource Encounter &quot;6-1-2&quot; Updated &quot;2019-07-14 19:26:23+0000&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: Ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'Ambulatory')</p><p><b>type</b>: Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT[US]</a>#11429006)</span></p><p><b>subject</b>: <a href=\"#Patient_1-2\">See above (Patient/1-2)</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/1-2"
        }
      },
      "response" : {
        "status" : "200"
      }
    },
    {
      "fullUrl" : "https://example.com/base/Encounter/7-1-2",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "7-1-2",
        "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\"><p><b>Generated Narrative: Encounter</b><a name=\"7-1-2\"> </a></p><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\">Resource Encounter &quot;7-1-2&quot; Updated &quot;2019-10-15 20:26:23+0000&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: Ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'Ambulatory')</p><p><b>type</b>: Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT[US]</a>#11429006)</span></p><p><b>subject</b>: <a href=\"#Patient_1-2\">See above (Patient/1-2)</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/1-2"
        }
      },
      "response" : {
        "status" : "200"
      }
    },
    {
      "fullUrl" : "https://example.com/base/Encounter/8-2",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "8-2",
        "meta" : {
          "lastUpdated" : "2020-06-15T20:26:23.217+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\"><p><b>Generated Narrative: Encounter</b><a name=\"8-2\"> </a></p><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\">Resource Encounter &quot;8-2&quot; Updated &quot;2020-06-15 20:26:23+0000&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: Ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'Ambulatory')</p><p><b>type</b>: Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT[US]</a>#11429006)</span></p><p><b>subject</b>: <a href=\"#Patient_1-2\">See above (Patient/1-2)</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/1-2"
        }
      },
      "response" : {
        "status" : "200"
      }
    },
    {
      "fullUrl" : "https://example.com/base/Provenance/1000002-1-2",
      "resource" : {
        "resourceType" : "Provenance",
        "id" : "1000002-1-2",
        "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\"><p><b>Generated Narrative: Provenance</b><a name=\"1000002-1-2\"> </a></p><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\">Resource Provenance &quot;1000002-1-2&quot; Version &quot;1&quot; Updated &quot;2019-07-14 19:26:23+0000&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-pdex-provenance.html\">PDex Provenance</a></p></div><p><b>target</b>: <a href=\"#Encounter_6-1-2\">See above (https://example.com/base/Encounter/6-1-2)</a></p><p><b>recorded</b>: Jul 10, 2020, 4:26:23 PM</p><h3>Agents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Who</b></td></tr><tr><td style=\"display: none\">*</td><td>Author <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-provenance-participant-type.html\">Provenance participant type</a>#author)</span></td><td><a href=\"Organization-ProviderOrg1.html\">Organization/ProviderOrg1</a> &quot;Provider 1&quot;</td></tr></table><h3>Entities</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Role</b></td><td><b>What</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>source</td><td><span>: No reference available</span></td></tr></table></div>"
        },
        "target" : [
          {
            "reference" : "https://example.com/base/Encounter/6-1-2"
          }
        ],
        "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/1000003-1-2",
      "resource" : {
        "resourceType" : "Provenance",
        "id" : "1000003-1-2",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2019-10-15T20:26:23.217+00:00"
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Provenance</b><a name=\"1000003-1-2\"> </a></p><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\">Resource Provenance &quot;1000003-1-2&quot; Version &quot;1&quot; Updated &quot;2019-10-15 20:26:23+0000&quot; </p></div><p><b>target</b>: <a href=\"#Encounter_7-1-2\">See above (Encounter/7-1-2)</a></p><p><b>recorded</b>: Jul 10, 2020, 4:26:23 PM</p><h3>Agents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Who</b></td></tr><tr><td style=\"display: none\">*</td><td>Author <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-provenance-participant-type.html\">Provenance participant type</a>#author)</span></td><td><a href=\"Organization-ProviderOrg1.html\">Organization/ProviderOrg1</a> &quot;Provider 1&quot;</td></tr></table><h3>Entities</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Role</b></td><td><b>What</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>source</td><td><span>: No reference available</span></td></tr></table></div>"
        },
        "target" : [
          {
            "reference" : "Encounter/7-1-2"
          }
        ],
        "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/1000004-1-2",
      "resource" : {
        "resourceType" : "Provenance",
        "id" : "1000004-1-2",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2019-12-31T20:26:23.217+00:00"
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Provenance</b><a name=\"1000004-1-2\"> </a></p><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\">Resource Provenance &quot;1000004-1-2&quot; Version &quot;1&quot; Updated &quot;2019-12-31 20:26:23+0000&quot; </p></div><p><b>target</b>: </p><ul><li><a href=\"#Patient_1-2\">See above (Patient/1-2)</a></li><li><a href=\"#Encounter_6-1-2\">See above (Encounter/6-1-2)</a></li><li><a href=\"#Encounter_7-1-2\">See above (Encounter/7-1-2)</a></li><li><a href=\"#Provenance_1000002-1-2\">See above (Provenance/1000002-1-2)</a></li><li><a href=\"#Provenance_1000003-1-2\">See above (Provenance/1000003-1-2)</a></li></ul><p><b>recorded</b>: Dec 31, 2019, 8:26:23 PM</p><h3>Agents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Role</b></td><td><b>Who</b></td></tr><tr><td style=\"display: none\">*</td><td>Transmitter <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-us-core-provenance-participant-type.html\">US Core Provenance Participant Type Extension Codes</a>#transmitter)</span></td><td>Transcriber <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-contractsignertypecodes.html\">Contract Signer Type Codes</a>#TRANS)</span></td><td><a href=\"Organization-Payer1.html\">Organization/Payer1</a> &quot;Payer 1&quot;</td></tr></table></div>"
        },
        "target" : [
          {
            🔗 "reference" : "Patient/1-2"
          },
          {
            "reference" : "Encounter/6-1-2"
          },
          {
            "reference" : "Encounter/7-1-2"
          },
          {
            "reference" : "Provenance/1000002-1-2"
          },
          {
            "reference" : "Provenance/1000003-1-2"
          }
        ],
        "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"
      }
    },
    {
      "fullUrl" : "https://example.com/base/Provenance/1000004-2",
      "resource" : {
        "resourceType" : "Provenance",
        "id" : "1000004-2",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2020-06-15T20:26:23.217+00:00"
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Provenance</b><a name=\"1000004-2\"> </a></p><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\">Resource Provenance &quot;1000004-2&quot; Version &quot;1&quot; Updated &quot;2020-06-15 20:26:23+0000&quot; </p></div><p><b>target</b>: <a href=\"#Encounter_8-2\">See above (Encounter/8-2)</a></p><p><b>recorded</b>: Jun 15, 2020, 8:26:23 PM</p><h3>Agents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Who</b></td></tr><tr><td style=\"display: none\">*</td><td>Author <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-provenance-participant-type.html\">Provenance participant type</a>#author)</span></td><td><a href=\"Organization-ProviderOrg1.html\">Organization/ProviderOrg1</a> &quot;Provider 1&quot;</td></tr></table><h3>Entities</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Role</b></td><td><b>What</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>source</td><td><span>: No reference available</span></td></tr></table></div>"
        },
        "target" : [
          {
            "reference" : "Encounter/8-2"
          }
        ],
        "recorded" : "2020-06-15T20:26:23.217+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/1000005-2",
      "resource" : {
        "resourceType" : "Provenance",
        "id" : "1000005-2",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2020-12-31T20:26:23.217+00:00"
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Provenance</b><a name=\"1000005-2\"> </a></p><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\">Resource Provenance &quot;1000005-2&quot; Version &quot;1&quot; Updated &quot;2020-12-31 20:26:23+0000&quot; </p></div><p><b>target</b>: <a href=\"Bundle-1000000-2.html\">Bundle/1000000-2</a></p><p><b>recorded</b>: Dec 31, 2019, 8:26:23 PM</p><h3>Agents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Role</b></td><td><b>Who</b></td></tr><tr><td style=\"display: none\">*</td><td>Transmitter <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-us-core-provenance-participant-type.html\">US Core Provenance Participant Type Extension Codes</a>#transmitter)</span></td><td>Transcriber <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-contractsignertypecodes.html\">Contract Signer Type Codes</a>#TRANS)</span></td><td><a href=\"Organization-Payer1.html\">Organization/Payer1</a> &quot;Payer 1&quot;</td></tr></table></div>"
        },
        "target" : [
          {
            🔗 "reference" : "Bundle/1000000-2"
          }
        ],
        "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"
      }
    }
  ]
}