Da Vinci Payer Data Exchange
2.0.0 - STU2 United States of America flag

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

: BundleExamplePayer3 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="1000000-3"/>
  <meta>
    <profile value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
  </meta>
  <type value="transaction-response"/>
  <timestamp value="2021-12-31T20:26:23.217+00:00"/>
  <link>
    <relation value="self"/>
    <url
         value="https://example.com/base/fhir/Patient?ct=W5sidG9rZW4iOiIrUklEOn53MThjQUk5RlVPZ0lEQUFBQUFBQU"/>
  </link>
  <entry>
    <fullUrl value="https://example.com/base/Patient/1-3"/>
    <resource>
      <Patient>
        <id value="1-3"/>
        <meta>
          <lastUpdated value="2021-01-07T13:26:22.0314215+00:00"/>
          <profile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
        </meta>
        <language value="en-US"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><p><b>Generated Narrative: Patient</b><a name="1-3"> </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;1-3&quot; Updated &quot;2021-01-07 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: https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901, Medical record number: 1234-234-1243-12345678901m, Health Plan Identifier: 1234-234-1243-12345678901u, Patient external identifier: 1234-234-1243-12345678901a</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>
        </text>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="MB"/>
            </coding>
          </type>
          <system
                  value="https://www.xxxhealthplan.com/fhir/memberidentifier"/>
          <value
                 value="https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901"/>
        </identifier>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="MR"/>
            </coding>
          </type>
          <system
                  value="https://www.xxxhealthplan.com/fhir/medicalrecordnumber"/>
          <value value="1234-234-1243-12345678901m"/>
        </identifier>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="XV"/>
            </coding>
          </type>
          <system
                  value="https://www.xxxhealthplan.com/fhir/uniquememberidentifier"/>
          <value value="1234-234-1243-12345678901u"/>
        </identifier>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PT"/>
            </coding>
          </type>
          <system value="https://www.xxxhealthplan.com/fhir/patacctnum"/>
          <value value="1234-234-1243-12345678901a"/>
        </identifier>
        <active value="true"/>
        <name>
          <family value="Appleseed"/>
          <given value="Johnny"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="(443)555-1212"/>
          <rank value="1"/>
        </telecom>
        <telecom>
          <system value="phone"/>
          <value value="(410)678-2323"/>
          <rank value="2"/>
        </telecom>
        <gender value="male"/>
        <birthDate value="1986-01-01"/>
        <address>
          <type value="physical"/>
          <line value="123 Main Street"/>
          <city value="Pittsburgh"/>
          <state value="PA"/>
          <postalCode value="12519"/>
        </address>
        <maritalStatus>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
            <code value="UNK"/>
          </coding>
        </maritalStatus>
      </Patient>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Encounter/6-1-2-3"/>
    <resource>
      <Encounter>
        <id value="6-1-2-3"/>
        <meta>
          <lastUpdated value="2021-01-14T19:26:23.217+00:00"/>
          <profile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Encounter</b><a name="6-1-2-3"> </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;6-1-2-3&quot; Updated &quot;2021-01-14 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.html">Patient/1-2</a> &quot; APPLESEED&quot;</p></div>
        </text>
        <status value="finished"/>
        <class>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
          <code value="AMB"/>
          <display value="Ambulatory"/>
        </class>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <version value="http://snomed.info/sct/731000124108"/>
            <code value="11429006"/>
            <display value="Consultation"/>
          </coding>
        </type>
        <subject>🔗 
          <reference value="Patient/1-2"/>
        </subject>
      </Encounter>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Encounter/7-1-2-3"/>
    <resource>
      <Encounter>
        <id value="7-1-2-3"/>
        <meta>
          <lastUpdated value="2021-01-15T20:26:23.217+00:00"/>
          <profile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Encounter</b><a name="7-1-2-3"> </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;7-1-2-3&quot; Updated &quot;2021-01-15 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_1-3">See above (Patient/1-3)</a></p></div>
        </text>
        <status value="finished"/>
        <class>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
          <code value="AMB"/>
          <display value="Ambulatory"/>
        </class>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <version value="http://snomed.info/sct/731000124108"/>
            <code value="11429006"/>
            <display value="Consultation"/>
          </coding>
        </type>
        <subject>
          <reference value="Patient/1-3"/>
        </subject>
      </Encounter>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Encounter/8-2-3"/>
    <resource>
      <Encounter>
        <id value="8-2-3"/>
        <meta>
          <lastUpdated value="2021-03-15T20:26:23.217+00:00"/>
          <profile
                   value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Encounter</b><a name="8-2-3"> </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;8-2-3&quot; Updated &quot;2021-03-15 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_1-3">See above (Patient/1-3)</a></p></div>
        </text>
        <status value="finished"/>
        <class>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
          <code value="AMB"/>
          <display value="Ambulatory"/>
        </class>
        <type>
          <coding>
            <system value="http://snomed.info/sct"/>
            <version value="http://snomed.info/sct/731000124108"/>
            <code value="11429006"/>
            <display value="Consultation"/>
          </coding>
        </type>
        <subject>
          <reference value="Patient/1-3"/>
        </subject>
      </Encounter>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000002-1-2-3"/>
    <resource>
      <Provenance>
        <id value="1000002-1-2-3"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2021-01-14T19:26:23.217+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><b>Generated Narrative: Provenance</b><a name="1000002-1-2-3"> </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;1000002-1-2-3&quot; Version &quot;1&quot; Updated &quot;2021-01-14 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_6-1-2-3">See above (https://example.com/base/Encounter/6-1-2-3)</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>
        </text>
        <target>
          <reference value="https://example.com/base/Encounter/6-1-2-3"/>
        </target>
        <recorded value="2020-07-10T16:26:23.217+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/ProviderOrg1"/>
          </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>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000003-1-2-3"/>
    <resource>
      <Provenance>
        <id value="1000003-1-2-3"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2021-10-01T20:26:23.217+00:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Provenance</b><a name="1000003-1-2-3"> </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;1000003-1-2-3&quot; Version &quot;1&quot; Updated &quot;2021-10-01 20:26:23+0000&quot; </p></div><p><b>target</b>: <a href="#Encounter_7-1-2-3">See above (Encounter/7-1-2-3)</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>
        </text>
        <target>
          <reference value="Encounter/7-1-2-3"/>
        </target>
        <recorded value="2020-07-10T16:26:23.217+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/ProviderOrg1"/>
          </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>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000005-2"/>
    <resource>
      <Provenance>
        <id value="1000005-2"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2021-10-01T20:26:23.217+00:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <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;2021-10-01 20:26:23+0000&quot; </p></div><p><b>target</b>: <a href="#Encounter_8-2-3">See above (Encounter/8-2-3)</a></p><p><b>recorded</b>: Mar 10, 2021, 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>
        </text>
        <target>
          <reference value="Encounter/8-2-3"/>
        </target>
        <recorded value="2021-03-10T16:26:23.217+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/ProviderOrg1"/>
          </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>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000004-1-2-3"/>
    <resource>
      <Provenance>
        <id value="1000004-1-2-3"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2019-12-31T20:26:23.217+00:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Provenance</b><a name="1000004-1-2-3"> </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;1000004-1-2-3&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_1-3">See above (Patient/1-3)</a></li><li><a href="#Encounter_6-1-2-3">See above (Encounter/6-1-2-3)</a></li><li><a href="#Encounter_7-1-2-3">See above (Encounter/7-1-2-3)</a></li><li><a href="#Provenance_1000002-1-2-3">See above (Provenance/1000002-1-2-3)</a></li><li><a href="#Provenance_1000003-1-2-3">See above (Provenance/1000003-1-2-3)</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>
        </text>
        <target>
          <reference value="Patient/1-3"/>
        </target>
        <target>
          <reference value="Encounter/6-1-2-3"/>
        </target>
        <target>
          <reference value="Encounter/7-1-2-3"/>
        </target>
        <target>
          <reference value="Provenance/1000002-1-2-3"/>
        </target>
        <target>
          <reference value="Provenance/1000003-1-2-3"/>
        </target>
        <recorded value="2019-12-31T20:26:23.217+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>
          <role>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
              <code value="TRANS"/>
            </coding>
          </role>
          <who>🔗 
            <reference value="Organization/Payer1"/>
          </who>
        </agent>
      </Provenance>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000004-2"/>
    <resource>
      <Provenance>
        <id value="1000004-2"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2020-06-15T20:26:23.217+00:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <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>: </p><ul><li><a href="#Encounter_8-2-3">See above (Encounter/8-2-3)</a></li><li><a href="#Provenance_1000005-2">See above (Provenance/1000005-2)</a></li></ul><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>
        </text>
        <target>
          <reference value="Encounter/8-2-3"/>
        </target>
        <target>
          <reference value="Provenance/1000005-2"/>
        </target>
        <recorded value="2020-06-15T20:26:23.217+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/ProviderOrg1"/>
          </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>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000005-2-3"/>
    <resource>
      <Provenance>
        <id value="1000005-2-3"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2020-12-31T20:26:23.217+00:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Provenance</b><a name="1000005-2-3"> </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;1000005-2-3&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>
        </text>
        <target>🔗 
          <reference value="Bundle/1000000-2"/>
        </target>
        <recorded value="2019-12-31T20:26:23.217+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>
          <role>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
              <code value="TRANS"/>
            </coding>
          </role>
          <who>🔗 
            <reference value="Organization/Payer1"/>
          </who>
        </agent>
      </Provenance>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
  <entry>
    <fullUrl value="https://example.com/base/Provenance/1000006-3"/>
    <resource>
      <Provenance>
        <id value="1000006-3"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2020-12-31T20:26:23.217+00:00"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Provenance</b><a name="1000006-3"> </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;1000006-3&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>
        </text>
        <target>🔗 
          <reference value="Bundle/1000000-2"/>
        </target>
        <recorded value="2019-12-31T20:26:23.217+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>
          <role>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
              <code value="TRANS"/>
            </coding>
          </role>
          <who>🔗 
            <reference value="Organization/Payer1"/>
          </who>
        </agent>
      </Provenance>
    </resource>
    <response>
      <status value="200"/>
    </response>
  </entry>
</Bundle>