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
: ExampleProvenancePayerSource - XML Representation
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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><b>Generated Narrative: Provenance</b><a name="1000005"> </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 "1000005" Version "1" 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><b>target</b>: <a href="MedicationDispense-1000001.html">MedicationDispense/1000001</a></p><p><b>recorded</b>: Jul 12, 2020, 6:26:23 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-Payer1.html">Organization/Payer1</a> "Payer 1"</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="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>